I.

Introduction

Case Abstract

The case study presented is about a patient with tuboovarian abcess, trichomoniasis, and acute gastroenteritis with slight dehydration. A tuboovarian abscess, is an inflammatory mass, filled with pus, involving the fallopian tube, ovary, and, occasionally, other adjacent pelvic organs such as the bowel or bladder. These abscesses are found most commonly in reproductive age women and typically result from upper genital tract infection. Tuboovarian abscess is a serious and potentially life-threatening condition. Aggressive

medical and/or surgical therapy is required and rupture of an abscess may result in sepsis. Trichomoniasis, on the other hand, is a sexually transmitted disease (STD) caused by a small organism called Trichomonas vaginalis. Symptoms include inflammation of the cervix, urethra, and vagina which produce an itching or burning sensation. Discomfort may increase during intercourse and urination. There may also be a yellow-green, itchy, frothy, foulsmelling ("fishy" smell) vaginal discharge. Lastly, acute gastroenteritis is characterized by an inflammation of the gastrointestinal tract that involves both the stomach and the small intestine, resulting in some combination of diarrhea, vomiting, and abdominal pain and cramping. It is usually caused by a virus, however, can be also caused by bacteria or parasites. The patient, M.J.F., a 26 year old female from Bohol, but currently living in Sta. Mesa, Manila, was admitted to Sta. Ana Hospital on January 20, 2014 due to vaginal discharge caused by trichomoniasis, and persistent nausea, vomiting (5x), loose bowel movement (5x), and abdominal pain. M.J.F. was transferred to an isolation room in the OB-GYN complex on the 5th floor. Two intravenous lines, D5LR, fast drip for the first 300cc, then regulated at 30 gtts/min and PNSS regulated at 30 gtts/min, were started to treat M.J.F.s slight dehydration and due to acute gastroenteritis and anti-biotics (Clindamycin, Gentamycin, and Metronidazole) were administered intravenously for the ongoing infection. Tramadol trough intravenous line, was given for pain. Hematology blood works were also requested, as with serum electrolytes, fecalysis, urinalysis, and liver function tests. Ultrasound was taken of the patients reproductive organs. Vital signs were monitored every 2 hours and perineal care was provided by the staff twice daily. The patients temperature fluctuated with on-off fever during different times of the days, however, would remain as normal for the most part. Paracetamol was given as needed. Our group handled M.J.F. on the dates of January 27, 28, 29, February 3, and 4. During this time, the patient experienced multiple signs and symptoms of other illnesses, which furthermore needed testing, however, since our group only handled the patient for a short span, a final diagnosis was limited. Furthermore, culture and sensitivity and gram staining

laboratory tests were ordered for vaginal secretions. The attending physician and health care team ruled out their initial probable diagnosis of dengue or measles. The patient was to be furthermore tested for HIV. Some medications were discontinued and several new antibiotics were added to the treatment regime which included oral Doxycycline and Ciprofloxacin and Betadine Solution mouthwash. The following case study presents the observations and experiences of the group during their handling of M.J.F.