Ulett et al. Journal of Medical Case Reports 2012, 6:237 http://www.jmedicalcasereports.com/content/6/1/237 C A S E R E P O R T JOURNAL OF MEDICAL CASE REPORTS Open Access Group B streptococcus cystitis presenting in a diabetic patient with a massive abdominopelvic abscess: a case report Kimberly B Ulett1,4*†, Jennifer H Shuemaker1†, William H Benjamin Jr2, Chee K Tan3 and Glen C Ulett2,3 Abstract Introduction: Streptococcus agalactiae or group B streptococcus is a Gram-positive pathogen that is typically associated with neonatal disease and infection in pregnant women. Group B streptococcus also causes invasive infections in non-pregnant adults including urinary tract infections. The spectrum of urinary tract infections caused by group B streptococcus includes cystitis, pyelonephritis, urosepsis and asymptomatic bacteriuria, which is particularly common among elderly individuals. A rare form of invasive group B streptococcus infection in adults is secondary abscess. Here, we present the first reported case of a patient who developed an unusual, massive abdominopelvic abscess secondary to acute group B streptococcus urinary tract infection. Case presentation: A 46-year-old African-American woman presented to the University Emergency Department complaining of urinary tract infection symptoms and severe abdominal pain. Diagnostic imaging by transvaginal ultrasound and computed tomography revealed a massive peripherally-enhancing, low-attenuating fluid collection within her pelvis. The patient’s abdominopelvic abscess was drained by ultrasound-guided drainage and this yielded a septic aspirate that was culture positive for abundant S. agalactiae. A recent history of urinary tract infection symptoms in the patient suggested that her abscess developed secondary to cystitis. Complete resolution of the abscess as a favorable outcome was achieved in this case following surgical drainage and appropriate antimicrobial therapy. Conclusion: Acute bacterial urinary tract infection leading to an abdominopelvic abscess has not previously been reported in the literature. This case report defines a new disease etiology associated with acute streptococcal cystitis and it will be of interest in cases of urinary tract infections where there is an association with abdominal and/or pelvic pain. A brief review of the literature on unusual secondary abscesses due to group B streptococcus is provided alongside this case to highlight the clinical significance and prognoses of these rare infections. Finally, this case emphasizes the requirement to distinguish unusual etiologies of pyogenic abscesses in order to guide successful clinical management and to treat patients with antibiotics active against the causal organism. Keywords: Abscess, Cystitis, Group B streptococcus, Streptococcus agalactiae, Urinary tract infection * Correspondence: Kimberly_Ulett@health.qld.gov.au †Equal contributors 1Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA 4Present affiliation: Department of Medicine, Royal Brisbane and Women’s Hospital, Bowen Bridge Road, Herston, Queensland 4006, Australia Full list of author information is available at the end of the article © 2012 Ulett et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.