MCQ – 98578

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:

Correct Answer » C Explanation

Statement 1: Bartholin’s abscess may be the likely diagnosis

• True.
• A painful unilateral vulval swelling in a reproductive-age woman is characteristic of a Bartholin gland abscess.
• Common symptoms include:
  • Pain while walking or sitting
  • Dyspareunia
  • Tender fluctuant swelling at the posterior vestibule (4 and 8 o’clock positions)

Statement 2: It is to be managed by marsupialization

• True.
• Marsupialization is the standard treatment for recurrent Bartholin cysts or abscesses.
• Acute abscesses may initially be treated with:
  • Incision and drainage
  • Word catheter placement
  • Antibiotics when indicated

Statement 3: Gonococcus is the most common pathogenic organism

• False.
• Bartholin abscesses are usually polymicrobial.
• The most common organism is Escherichia coli.
• Other organisms include:
  • Bacteroides
  • Streptococci
  • Staphylococcus aureus
  • Neisseria gonorrhoeae (less common)