title: Treatment strategy for pelvic actinomycosis: case report and review of the literature.
abstract: BACKGROUND
  Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by an anaerobic Gram positive organism Actinomyces israelii usually associated with intra-uterine devices. Pelvic actinomycosis can mimick pelvic or intra-abdominal malignancy leading to mutilating surgical exeresis.
  
  
  RESULTS
  We present a pelvic actinomycosis secondary to long-standing intra-uterine device use in a 50-year old European woman treated by intravenous antibiotic therapy, and then by a total abdominal hysterectomy and bilateral salpingoophorectomy to free the pelvis from abscess. We point out the difficulty in diagnosis, and the importance of high-dose intravenous antibiotic therapy to reduce the very high risk for nearby pelvic structure injuries, reported in the literature, leading to post-operative morbidity.
authors.affiliation: Department of Obstetrics and Gynecology. University Hospital of Strasbourg, 67098, Strasbourg, France.
authors.forename: D
authors.initials: D
authors.lastname: Hamid
authors.forename: J J
authors.initials: JJ
authors.lastname: Baldauf
authors.forename: C
authors.initials: C
authors.lastname: Cuenin
authors.forename: J
authors.initials: J
authors.lastname: Ritter
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis / Q000628:therapy*; D000291:Adnexal Diseases / Q000175:diagnosis / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents