{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T15:47:35Z","timestamp":1773848855925,"version":"3.50.1"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T00:00:00Z","timestamp":1685404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>\n                      infrequently causes genital tract infections but - in particular predisposing circumstances - it can be a transient part of vaginal flora and thus pelvic infections can occur.\n                    <\/jats:p>\n                    <jats:p>Possible conditions associated with pneumococcal pelvic-peritonitis include the use of intrauterine contraceptive devices, recent birth and gynecologic surgery. The underlying mechanism of these occurrences is likely to be the ascending infection from the genital tract via the fallopian tubes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>\n                      We present a case of pelvic-peritonitis and pneumonia due to\n                      <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>\n                      in a healthy young woman wearing a menstrual endovaginal cup.\n                    <\/jats:p>\n                    <jats:p>Following the radiological findings of a cystic formation in the right ovary and ascites effusions in all peritoneal recesses an emergency exploratory laparoscopy with right ovariectomy was performed. After resolution of abdominal sepsis, parenchymal consolidation complicated into necrotizing pneumonia, hence the patient underwent a right lower lobectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>The menstrual cup is a self-retaining intravaginal menstrual fluid collection device, considered as a safe alternative to tampons and pads, which use is associated with rare adverse effects.<\/jats:p>\n                    <jats:p>Few cases of infectious disease have been described, where the underlying mechanism may consist of bacterial replication within the blood accumulated in the uterine environment, with subsequent ascension into the genital tract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In the rare occurrence of pneumococcal pelvic-peritonitis considering all possible infectious sources is paramount, as is assessing the possible involvement of intravaginal devices, increasingly used nowadays but of which potential complications are still poorly described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2023.108375","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T11:27:38Z","timestamp":1685446058000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["A case of pneumococcal pneumonia and pelvic-peritonitis in a menstrual endovaginal cup user, which came first?"],"prefix":"10.1097","volume":"107","author":[{"given":"Alberto","family":"Calabrese","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Fornaciari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Compagnone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Barbagallo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cinzia","family":"Fornaciari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Bellini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-72-20260318","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1179\/acb.2008.082","article-title":"Pelvic inflammatory disease due to streptococcus pneumoniae: a usual pathogen at an unusuak place","volume":"63","author":"Lemoyne","year":"2008","journal-title":"Acta Clin. Belg"},{"key":"R2-72-20260318","doi-asserted-by":"crossref","first-page":"e69","DOI":"10.1086\/318710","article-title":"Understanding the bacterial flora of the female genital tract","volume":"32","author":"Larsen","year":"2001","journal-title":"Clin. Infect. Dis"},{"key":"R3-72-20260318","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 guideline: updating consensus Surgical Case Report (SCARE) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int. J. Surg"},{"key":"R4-72-20260318","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1093\/cid\/civ312","article-title":"Mycoplasma genitaliumInfection and female reproductive tract disease: a meta-analysis","volume":"61","author":"Lis","year":"2015","journal-title":"Clin. Infect. Dis"},{"key":"R5-72-20260318","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1093\/clinids\/12.3.416","article-title":"Streptococcus pneumoniae infections of the female genital tract and in the newborn child","volume":"12","author":"Westh","year":"1990","journal-title":"Clin. Infect. Dis"},{"key":"R6-72-20260318","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/IPC.0000000000000843","article-title":"Disseminated Streptococcus pneumoniae infection associated with an intrauterine device","volume":"28","author":"Roberts","year":"2020","journal-title":"Infect. Dis. Clin. Pract"},{"key":"R8-72-20260318","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1002\/bjs.6822","article-title":"Diagnosis and treatment of spontaneous group a streptococcal peritonitis","volume":"97","author":"Monneuse","year":"2009","journal-title":"Br. J. 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