A Bartholin gland sometimes forms a cyst or abscess. A cyst is thought to occur from occlusion of the ostium, which leads to distension of the gland with fluid. An abscess is a primary infection of the gland by pathogenic bacteria. The highest incidence occurs in women aged 20-29 years. Occurrence in those older than 40 years is rare and should raise concerns about malignancy as an alternative cause.
Fever occurs in approximately one third of patients.
Spontaneous rupture may occur. If spontaneously ruptured, the mass decompresses and may yield few findings other than discharge, which may be purulent if an abscess has formed. Other organisms cultured include staphylococcal and streptococcal species, gram-negative enteric bacteria, and Chlamydia trachomatis . Blood tests are not necessary to evaluate an uncomplicated abscess or cyst. Consider syphilis serology, as abscesses are often caused by sexually transmitted organisms.