Tubo-ovarian abscess in a young child with suspected Prader-Willi syndrome: a complication of childhood obesity.

Tubo-ovarian abscess (TOA) is an exceptionally rare diagnosis in prepubertal girls and typically arises through mechanisms distinct from pelvic inflammatory disease. We report the case of a girl in her early childhood with severe obesity and clinical features suggestive of Prader-Willi syndrome who presented with acute abdominal pain and systemic sepsis. Diagnostic laparoscopy was undertaken for suspected perforated appendicitis and revealed a ruptured TOA caused by Group A Streptococcus Surgical drainage and targeted antimicrobial therapy resulted in complete recovery. This case highlights the diagnostic challenges of acute abdominal pain in young children, the importance of maintaining a broad differential diagnosis, and the possibility that syndromic obesity may predispose to atypical and severe infections.