Loculated Fluid Visualized in Hepatorenal Space with Point-of-care Ultrasound in Patient with Pelvic Inflammatory Disease Caused by Group A Streptococcus: Case Report

Introduction: Point-of-care ultrasound (POCUS) is a screening and diagnostic modality frequently used in the emergency department to assess patients with abdominal pain. Case Report: We present a case describing the unusual finding of intraperitoneal fluid with loculations visualized in the right up...

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Main Authors: Neil Makhijani, Samuel E. Sondheim, Turandot Saul, Elizabeth Yetter
Format: Article
Language:English
Published: eScholarship Publishing, University of California 2024-08-01
Series:Clinical Practice and Cases in Emergency Medicine
Online Access:https://escholarship.org/uc/item/9k09v5qh
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author Neil Makhijani
Samuel E. Sondheim
Turandot Saul
Elizabeth Yetter
author_facet Neil Makhijani
Samuel E. Sondheim
Turandot Saul
Elizabeth Yetter
author_sort Neil Makhijani
collection DOAJ
description Introduction: Point-of-care ultrasound (POCUS) is a screening and diagnostic modality frequently used in the emergency department to assess patients with abdominal pain. Case Report: We present a case describing the unusual finding of intraperitoneal fluid with loculations visualized in the right upper quadrant of the abdomen in a patient ultimately diagnosed with pelvic inflammatory disease (PID) with ruptured tubo-ovarian abscess caused by group A streptococcus (GAS), a pathogen rarely implicated in the disease. Conclusion: Uncommon findings on abdominal POCUS should trigger further investigation. In a patient not responding to antibiotics administered for typical PID coverage, GAS should be considered as a possible etiology and a penicillin-based antibiotic administered to prevent progression to tubo-ovarian-abscess formation, peritonitis, and sepsis.
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series Clinical Practice and Cases in Emergency Medicine
spelling doaj-art-15537e0700ef45cab0014ea833eafe6c2025-08-20T02:43:50ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2024-08-018432232510.5811/cpcem.6663cpcem-8-322Loculated Fluid Visualized in Hepatorenal Space with Point-of-care Ultrasound in Patient with Pelvic Inflammatory Disease Caused by Group A Streptococcus: Case ReportNeil Makhijani0Samuel E. Sondheim1Turandot Saul2Elizabeth Yetter3Mount Sinai Morningside-Mount Sinai West, Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New YorkMount Sinai Morningside-Mount Sinai West, Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New YorkMount Sinai Morningside-Mount Sinai West, Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New YorkMount Sinai Morningside-Mount Sinai West, Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New YorkIntroduction: Point-of-care ultrasound (POCUS) is a screening and diagnostic modality frequently used in the emergency department to assess patients with abdominal pain. Case Report: We present a case describing the unusual finding of intraperitoneal fluid with loculations visualized in the right upper quadrant of the abdomen in a patient ultimately diagnosed with pelvic inflammatory disease (PID) with ruptured tubo-ovarian abscess caused by group A streptococcus (GAS), a pathogen rarely implicated in the disease. Conclusion: Uncommon findings on abdominal POCUS should trigger further investigation. In a patient not responding to antibiotics administered for typical PID coverage, GAS should be considered as a possible etiology and a penicillin-based antibiotic administered to prevent progression to tubo-ovarian-abscess formation, peritonitis, and sepsis.https://escholarship.org/uc/item/9k09v5qh
spellingShingle Neil Makhijani
Samuel E. Sondheim
Turandot Saul
Elizabeth Yetter
Loculated Fluid Visualized in Hepatorenal Space with Point-of-care Ultrasound in Patient with Pelvic Inflammatory Disease Caused by Group A Streptococcus: Case Report
Clinical Practice and Cases in Emergency Medicine
title Loculated Fluid Visualized in Hepatorenal Space with Point-of-care Ultrasound in Patient with Pelvic Inflammatory Disease Caused by Group A Streptococcus: Case Report
title_full Loculated Fluid Visualized in Hepatorenal Space with Point-of-care Ultrasound in Patient with Pelvic Inflammatory Disease Caused by Group A Streptococcus: Case Report
title_fullStr Loculated Fluid Visualized in Hepatorenal Space with Point-of-care Ultrasound in Patient with Pelvic Inflammatory Disease Caused by Group A Streptococcus: Case Report
title_full_unstemmed Loculated Fluid Visualized in Hepatorenal Space with Point-of-care Ultrasound in Patient with Pelvic Inflammatory Disease Caused by Group A Streptococcus: Case Report
title_short Loculated Fluid Visualized in Hepatorenal Space with Point-of-care Ultrasound in Patient with Pelvic Inflammatory Disease Caused by Group A Streptococcus: Case Report
title_sort loculated fluid visualized in hepatorenal space with point of care ultrasound in patient with pelvic inflammatory disease caused by group a streptococcus case report
url https://escholarship.org/uc/item/9k09v5qh
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