LACTOCOCCUS GARVIEAE AND FUNGAL CO-INFECTION FINDINGS IN WOMEN WITH PELVIC INFLAMMATORY DISEASE, INFERTILITY, BILATERAL TUBAL OBSTRUCTION, HYDROSALPINX, AND OVARIAN CYST

Abstrak

Introduction: Pelvic Inflammatory Disease (PID) is an ascending infection of the female upper genital tract, including the uterus, fallopian tubes, and other pelvic structures. It is a significant cause of reproductive morbidity, where recurrent or untreated PID episodes may lead to infertility. While the primary pathogens are Chlamydia trachomatis and Neisseria gonorrhoeae, polymicrobial infections involving anaerobic bacteria and atypical pathogens, such as Lactococcus garvieae, have emerged. L. garvieae, previously recognized as a pathogen in fish and livestock, is now identified as a cause of systemic and genitourinary infections in humans, including PID. Case Presentation: This report presents a case of PID caused by Lactococcus garvieae and Candida infection in a 25-year-old woman with bilateral tubal obstruction, hydrosalpinx, and ovarian cyst, resulting in infertility. The patient experienced chronic pelvic pain, dysmenorrhea, and a palpable abdominal mass. Transvaginal ultrasonography revealed a unilocular cystic mass in the right ovary with a ground-glass appearance, suggesting endometriosis. Laparoscopic findings confirmed a left ovarian cyst with dense adhesions, bilateral hydrosalpinx, and tubal obstruction. Microbiological examination identified L. garvieae and Candida species. Discussion:  This case highlights the importance of considering atypical pathogens in PID diagnosis. Lactococcus garvieae, although uncommon, can lead to significant reproductive complications. Comprehensive diagnostic and therapeutic approaches are crucial in managing such infections to prevent long-term fertility issues. Conclusion: The identification of L. garvieae as an etiological agent in PID underscores the need for heightened clinical awareness. Early recognition and tailored therapy are essential to mitigate the risk of chronic pelvic adhesions and infertility.