Ferjaoui MA, Arfaoui R, Khedhri S, Hannechi MA, Abdessamia K, Samaali K, Fezai W, Salhi M, Malek M, Neji K. Pelvic actinomycosis: A confusing diagnosis.
Int J Surg Case Rep 2021;
86:106387. [PMID:
34507193 PMCID:
PMC8433244 DOI:
10.1016/j.ijscr.2021.106387]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/02/2021] [Accepted: 09/02/2021] [Indexed: 12/05/2022] Open
Abstract
Introduction and importance
Actinomycosis is a rare chronic and suppurative infection caused by anerobic Gram Positive bacteria: actinomyces. Pelvic location is extremely rare, usually associated with history of IUD contraception and doesn't have specific signs. Pelvic actinomycosis diagnosis may be confused with pelvic gynecologic malignancies or abscess. We present a retrospective and descriptive study of twelve patients with pelvic actinomycosis diagnosed and managed in our department from January 2000 to December 2011.
Cases presentation
The patients' mean age was 47 years. 75% of them had a history of IUD for a mean period of 8,44 years. Pelvic pain was the most common complaint. In four cases, pre-operative clinical presumption was tubo-ovarian abscess. Gynecologic malignancies were suspected in 8 patients. Pelvic actinomycosis management was based on surgery and long-term antibiotic.
Clinical discussion
Pelvic actinomycosis is an extremely rare chronic infection, presenting 3% of human actinomycosis. Common clinical presentations include vaginal discharge, tubo-ovarian abscess and pelvic tumors mimicking gynecologic malignancies. It is difficult to diagnose. Association with IUD history was recognized. Management is based on surgery and long-term antibiotic administration.
Conclusion
Pelvic actinomycosis is an extremely rare chronic infection. This entity is difficult to diagnose. Accurate diagnosis can reduce complications and unnecessary surgeries, and can preserve fertility.
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