Atypical Presentation of Pelvic Abscess: A Case Report

An abscess is a common disease worldwide and its diagnosis is usually straightforward. However, pelvic abscess is rarely seen in daily clinical practice. Besides, it is a challenge for the surgeon to diagnose abscesses in unusual location, including the pelvis. A 41-year-old housewife lady had a history of poorly controlled insulin-dependent diabetes mellitus with recurrent vaginitis, cervicitis, and recurrent urinary tract infection. She presented with bilateral hip joint pain and limitation in her movement, with diabetic ketoacidosis. She was admitted to the hospital for the treatment of diabetic ketoacidosis. A physical examination revealed a high-grade fever, unwell, and there is a pelvic mass. Laboratory tests showed leukocytosis and a low hemoglobin level. Ultrasonography and computerized tomography revealed a 5 × 5 pelvic mass, which was located anterior to the bladder, with a high suspicion of an abscess formation. The patient was admitted to the surgical ward and drainage of the abscess under general anesthesia with antibiotic cover was performed. The patient was discharged two weeks postoperatively with an improvement in all presenting features. Bilateral insidious hip joint pain with limitation of movement should orient the clinician to a pelvic abscess as one of the differential diagnoses of these symptoms.