BARTHOLINS GLAND ABSCESS Flashcards
General considerations of Bartholin’s Gland Abscess.
(1) Trauma or infection may involve the Bartholin duct, causing obstruction of the gland.
(2) Drainage of secretions is prevented thus leading to pain, swelling, and abscess formation.
(3) The infection usually resolves, and pain disappears,
(a) stenosis of the duct outlet with distention often persists.
(4) Reinfection causes recurrent tenderness and further enlargement of the duct.
Pertinent anatomy of Bartholin’s Gland Abscess.
(1) Bartholin gland
(2) Vagina
Signs and symptoms of Bartholin’s Gland Abscess.
(1) Periodic painful swelling on either side of the introitus
(2) Dyspareunia
(3) Fluctuant swelling 1-4 cm in diameter lateral to either labium minus
(a) Sign of occlusion of Bartholin duct
(4) Tenderness is evidence of active infection
Differential diagnosis of Bartholin’s Gland Abscess.
(1) Infection can be caused by
(a) Gonorrhea
(b) Chlamydia
(c) Polymicrobial
Laboratory findings of Bartholin’s Gland Abscess.
(a) Purulent drainage should be cultured for
1) Chlamydia
2) Gonorrhea
3) Other pathogens
Imaging of Bartholin’s Gland Abscess.
None
Treatment of Bartholin’s Gland Abscess.
(4) Aspiration or incision and drainage of the abscess
(a) May reoccur
(5) Antibiotics are unnecessary unless cellulitis is present
(a) If STI is suspected but culture is not available presumptively treat for
both Gonorrhea (ceftriaxone 250mg IM x1) and Chlamydia
(azithromycin 1g PO x1)
(6) Frequent warm soaks
(7) Marsupialization may be required for frequent reoccurrence
(8) Women under 40 years of age, asymptomatic cysts do not require therapy
(9) Women over age 40, biopsy or removal are recommended to rule out vulvar carcinoma
Follow up of Bartholin’s Gland Abscess.
(1) May need referral to OB-GYN for reoccurrences
(a) Surgical therapy (marsupialization) is indicated
