| A clinical analysis of pelvic actinomycosis. |
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Jei Jun Bae, Jin Hee Kim, Yoon Kee Park, Doo Jin Lee, Min Whan Koh, Tae Hyung Lee, Sung Ho Lee |
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Department of Obstetrics and Gynecology, Yeungnam University, College of Medicine, Daegu, Korea. shlee@med.yu.ac.kr |
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| Abstract |
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OBJECT: Pelvic actinomycosis is a relatively rare chronic suppurative and granulomatous infectious disease, caused by a gram-positive anaerobic bacteria. Actinomyces israelli is the most common subtype in human disease commonly associated with intrauterine device (IUD). This study was designed to analyze clinical and laboratory characteristics of patients with pelvic actinomycosis. METHODS: We reviewed medical records of 12 patients with pelvic actinomycosis who were admitted between January 1, 1995 and December 31, 2005. The clinical characteristics, diagnostic evaluation and surgical treatment results were retrospectively analyzed. RESULTS: The ages of the cases varied between 30 and 53 years old. Of the 12 patients, 11 patients had been using an IUD. Two cases had hydronephrosis due to infection. All our cases involved ovary and/or uterus and had predisposing factors of disease progression, including IUD, dilatation and curretage. Most common presenting symptom of patients were abdominal pain (75%). Preoperatively, 5 cases were diagnosed as actinomycosis, but 7 cases misconceived as a pelvic malignancy, secondary degenerated myoma and tuboovarian abscess. Exploration were performed in all patients. All cases were cured following surgery with subsequent antibiotics. CONCLUSION: Actinomycosis should be considered preoperatively, especially in long-term IUD usage, fever and laboratory findings that indicate the presence of pelvic infection. Radiologic findings (CT) can assist in making the diagnosis of pelvic actinomycosis. Appropriate antibiotics, as well as surgery, are important in the treatment of pelvic actinomycosis. |
| Key Words:
Pelvic actinomycosis, Intrauterine devices (IUD) |
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