Background: Tuboovarian abscesses (TOAs) are a somewhat unusual finding in postmenopausal patients without risk factors. We present a rare case of unilateral TOA initially presenting as a brain abscess in a postmenopausal woman.
Case: A 61-year-old woman presented with a complaint of forgetfulness, nausea and vomiting, with lower abdominal pain and diarrhea. She was found to have a brain abscess, which was treated by craniotomy, with drainage of the abscess, and intravenous antibiotics. The patient was subsequently found to have a pelvic mass, which, on laparotomy, was a unilateral TOA. Pathology demonstrated that the abscess contained vegetable matter consistent with origin in a ruptured diverticulum.
Conclusion: Diagnosis of a brain abscess should prompt a thorough investigation for a primary infectious source, including the gastrointestinal and genitourinary tracts.