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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (2): 306-308    DOI: 10.31083/j.ceog.2020.02.5158
Case Report Previous articles | Next articles
Severe pelvic actinomycosis with intrauterine device in situ and abdominal wall involvement treated with medication only: case report
H. J. Wang1, Y. H. Wu1, P. S. Huang1, 2, *()
1Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei City, Taiwan
2Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
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Abstract  

Pelvic actinomycosis is a rare, granulomatous disease, caused by the gram-positive anaerobic bacteria, Actinomyces. It is usually associated with recent abdominopelvic surgery or intrauterine contraceptive device placement. The diagnosis is difficult because of the similarity with malignancy, inflammatory bowel disease, and tuberculosis. Although intrauterine device related actinomycosis is considered a well-documented diagnosis, there are intermittent case reports of unusual presentations. Appropriate image survey can aid clinicians in its diagnosis and treatment of pelvic actinomycosis and further prevent unnecessary invasive intervention. Here the authors present a case of suspected pelvic actinomycosis with abdominal wall involvement supported with images and describe the clinical manifestations. The disease with abdominal wall involvement and treated with empirical antibiotics administration only has yet to be reported.

Key words:  Actinomycosis      Pelvic infection      Intrauterine device      Computed tomography     
Published:  15 April 2020     
*Corresponding Author(s):  P. S. Huang     E-mail:  muse_caffeine@hotmail.com

Cite this article: 

H. J. Wang, Y. H. Wu, P. S. Huang. Severe pelvic actinomycosis with intrauterine device in situ and abdominal wall involvement treated with medication only: case report. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 306-308.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.02.5158     OR     https://ceog.imrpress.com/EN/Y2020/V47/I2/306

Figure 1.  — (A) Diffuse thickening of left pelvic wall muscles with fusiform appearance that is anteriorly bulging out to subcutaneous region (arrow). A septate capsulated mass lesion with fine air content in the left adnexa (arrowheads). (B) Intrauterine device in situ. (C) Image with contract on the third month. Although the left adnexal mass had decreased, irregular wall of the mass and the fatty stranding of adjacent subcutaneous region are still noted. (D) Image with contract on the sixth month. A small soft tissue nodule in the pelvis, suggesting the granulation after medical treatment.

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