First report of Anaerococcus tetradius in bilateral tubo-ovarian abscess following intra-uterine device insertion.

Tubo-ovarian abscess (TOA) is a life-threatening complication of pelvic inflammatory disease. A 30-year-old woman presented with bilateral tubo-ovarian abscesses, one week after the insertion of a levonorgestrel-releasing intrauterine device. The patient required intensive care management with intravenous antibiotics, along with ultrasound-guided abscess drainage. Anaerobic culture of the aspirated pus samples (3) yielded Anaerococcus tetradius. The patient recovered fully after 17 days of hospital stay. This is the first documented case of Anaerococcus tetradius isolated from a bilateral TOA, likely from subclinical bacterial vaginosis exacerbated by IUD insertion. This report raises the possibility of the unrecognised pathogenic potential of A. tetradius.