title: Pelvic actinomycosis in menopause: a case report.
abstract: OBJECTIVE
  To examine the association between the use of intra uterine device (IUD) and the risk of actinomycosis in postmenopausal women.
  
  
  METHODS
  We report a case of pelvic actinomycosis in a postmenopausal woman who was wearing an IUD for 14 years until 20 months after the beginning of menopause. In the last 5 years the patient had been suffering occasionally from pain, abdominal tension and rectal tenesmus. The disease was revealed clearly 18 months after removing the intrauterine device.
  
  
  RESULTS
  The diagnosis of pelvic actinomycosis was only possible after hysterectomy, bilateral oophorectomy and multiple biopsies. At histological features a focus with actynomycetes colonies was evident.
  
  
  CONCLUSIONS
  This study supports the previously reported association between the pelvic location of actinomycosis and the use of the IUD. The removal of IUD should be mandatory in postmenopausal women.
authors.affiliation: Chair of Obstetrics and Gynecology, Second University of Naples, via Santa Lucia n.39, 80132 Naples, Italy. luigicobellis@yahoo.it
authors.forename: L
authors.initials: L
authors.lastname: Cobellis
authors.forename: E M
authors.initials: EM
authors.lastname: Messalli
authors.forename: G
authors.initials: G
authors.lastname: Pierno
mesh_terms: D000190:Actinomyces / Q000302:isolation & purification; D000196:Actinomycosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007434:Intrauterine Devices / Q000009:adverse effects*; D008875:Middle Aged; D010052:Ovariectomy; D000292:Pelvic Inflammatory Disease / Q000209:etiology* / Q000601:surgery; D017698:Postmenopause