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Question

A 22 year old woman comes with complaints of pain and discomfort in vaginal region. On examination there is unilateral tender swelling in the posterior half of labium minus, overlying skin is red and edematous. What is the most probable diagnosis?

The correct answer is
Bartholin's abscess

Diagnosis of Bartholin's Abscess

The patient presents with symptoms highly suggestive of a localized infection in the vulvar region.

  • Key Symptoms: Unilateral (one-sided) tender swelling, located in the posterior half of the labium minus, with overlying skin appearing red and swollen (edematous).
  • Location: The posterior part of the labium minus is close to the vaginal opening, where the Bartholin's glands are situated.

Bartholin's Gland Function and Pathology

The Bartholin's glands produce lubrication. If the duct of one of these glands becomes blocked (often due to infection or injury), secretions can accumulate, leading to a cyst. If this cyst becomes infected, it can form an abscess.

  • Abscess Presentation: A Bartholin's abscess typically causes a painful, red, and swollen lump in the labia, matching the patient's description.

Evaluating Other Options

  • Utero vaginal prolapse: This involves the descent of pelvic organs and presents as a bulge from the vagina, not a localized labial swelling.
  • Inversion of uterus: A rare condition where the uterus turns inside out, usually related to childbirth, with different symptoms.
  • Trichomoniasis: A parasitic infection causing vaginitis, characterized by itching, burning, and discharge, but not a discrete, unilateral, tender lump.

Therefore, based on the unilateral, tender, red, and edematous swelling localized to the labium minus, a Bartholin's abscess is the most probable diagnosis.

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Important Questions from Infections in Genital Tract

  1. Which of the following are characteristics of Trichomonas vaginitis?
    1. Presence of greenish frothy discharge
    2. Vaginal pH > 4.5
    3. Presence of clue cells in microscopic examination
    4. Strawberry spots on the vaginal mucosa
    Select the correct answer using the code given below:

  2. Monilial vaginitis is commonly associated with all EXCEPT:
  3. A 30 year old lady, P2L2 presents with painful unilateral swelling in vulva for 3 days. Which
    of the following statements are true regarding the above case?
    1. Bartholin's abscess may be the likely diagnosis
    2. It is to be managed by marsupialisation
    3. Gonococcus is the most common pathogenic organism
    Select the correct answer using the code given below:
  4. Which of the following is NOT a characteristic clinical feature of Bacterial Vaginosis?
  5. Which of the following are risk factors for developing pelvic inflammatory disease in females ?
    1. Use of oral contraception pills
    2. Multiple sexual partners
    3. Lower socioeconomic status
    4. Genetic predisposition
    Select the correct answer using the code given below :
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