{"paper_id":"9404b2fb-f282-4ae3-ab5f-8bab549e15a0","body_text":"Abstract\nCase\nA 42-year-old lady presented to the OPD with pyrexia of unknown origin, cough, and lower abdominal pain. Clinically, she was febrile and had a tender pelvic mass. Flu panel was negative with evidence of leptospira IgM being strongly positive. Scan confirmed a large left tubo-ovarian abscess in an endometrioma. Laparoscopic drainage and excision of the abscess with left salpingo-oophorectomy with were done. Postoperatively, she was given complete course of antibiotics and recovered well within 48 h.\nDiscussion\nEndometriosis is a chronic inflammatory state mostly seen in reproductive age group of women. Blood being a perfect culture medium for the growth of pathogens allows infections to grow, especially in states of low immunity. Hematogeneous spread from distant sites like lungs, liver, or ascending infections via vagina is possible routes of infection in an endometrioma.\nConclusion\nIf the infection is not treated timely, it may lead to abscess and further sepsis, needing fertility compromising surgeries like salpingectomy, oophorectomy. Hence, proper counseling and follow-up of patients with endometriosis are essential.\nSimilar content being viewed by others\nReferences\nEuropean Society of Human Reproduction and Embryology. Information for Women with Endometriosis [https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline/Patient-version.aspx]. (Accessed on 27.01.2025)\nFouks Y, Cohen A, Shapira U, et al. Surgical intervention in patients with tubo-ovarian abscess: clinical predictors and a simple risk score. J Minim Invasive Gynecol. 2019;26(3):535–43.\nTao X, Ge SQ, Chen L, et al. Relationships between female infertility and female genital infections and pelvic inflammatory disease: a population-based nested controlled study. Clinics (Sao Paulo). 2018;09(73):e364.\nCho HW, Koo YJ, Min KJ, et al. Pelvic inflammatory disease in virgin women with tubo-ovarian abscess: a single-center experience and literature review. J Pediatr Adolesc Gynecol. 2017;30:203–8.\nLevett PN. Leptospirosis. Clin Microbiol Rev. 2001;14:296–326.\nAdler B, de la Peña Moctezuma A. Leptospira and leptospirosis. Vet Microbiol. 2010;140(3–4):287–96. https://doi.org/10.1016/j.vetmic.2009.03.012.\nZondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382:1244–56.\nAcknowledgements\nTeam Creation, Fortis hospital, Bannerghatta road, Bangalore-560076 . We also acknowledge the valuable contribution of our senior Physician, Dr Sheela Chakravarthy in the management of this case.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nConflict of Interest\nThe author declare that they have no Conflict of interest.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nDr Manisha Palep Singh Additional Director of Department of Obstetrics and Gynaecology, MBBS, DM Reproductive Medicine UK, FRCOG, MRCOG, CCT UK, MD OBG, DNB; Dr Raksha Kumaraswamy MBBS MS OBG, MRCOG, DNB OBG, EBCOG, Fellowship in IVF and infertility, Fellowship in high risk pregnancy.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nSingh, M.P., Kumaraswamy, R. Leptospira-Associated Tubo-Ovarian Abscess in an Endometrioma: A Rare Case Report. J Obstet Gynecol India (2026). https://doi.org/10.1007/s13224-026-02354-2\nReceived:\nAccepted:\nPublished:\nVersion of record:\nDOI: https://doi.org/10.1007/s13224-026-02354-2","source_license":"CC0","license_restricted":false}