[Hydronephrosis in course of actinomycosis of female reproductive organs].
OBJECTIVE
Pelvic actinomycosis is a chronic suppurative granulomatous disease caused by an anaerobic Gram positive germ, Actinomyces. The most difficult task was to obtain the diagnosis in a patient with an intrauterine device and poor general health, signs of infection and a pelvic syndrome.


RESULTS
This is a report of a case of hydronephrosis in course of actinomycosis of female reproductive organs in a patient aged 46 years with the intrauterine contraceptive device admitted to The Department of Gynecology & Obstetric in Hospital of Słupsk. Symptoms were presented as an acute abdomen associated with painful epigastric and mass in right adnexa. A pre-operative diagnosis of the right hydronephrosis, on ovarian tumor and uterus myoma were detected which lead to an extensive and difficult surgery. The pathologic process infiltrated the retroperitoneal space simulated sarcoma or lymphoma. The disease was serious and required hysterectomy with salpingo-oophorectomy and intra-abdominal drainage. Actinomycosis was confirmed by the postoperative histopathologic examination, and the patient was successfully treated with penicillin. The patient was completely free of symptoms two months within the operation.


CONCLUSIONS
In patients who have intrauterine contraceptive devices or who have had them removed recently, abdominal pain, recurrent vaginal bleeding or adnexal masses should prompt a thorough search for potentially pathogenic actinomyces in the genital tract.
Iwaszko
Rafał
R
Oddziału Połozniczo-Ginekologicznego Samodzielnego Publicznego Szpitala Zespolonego w Słupsku.
Studziński
Zbigniew
Z
D000196:Actinomycosis / Q000150:complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D007044:Hysterectomy; D007434:Intrauterine Devices / Q000009:adverse effects*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome