[Abdominopelvic actinomycosis: a tumoral syndrome due to bacterial infection].
The purpose of this review is to define the diagnostic steps and treatment of abdominopelvic actinomycosis. Three cases are described which illustrate the variety of clinical presentations ranging from acute peritonitis to chronic pseudo-tumor. The diagnosis of actinomycosis is rarely made pre-operatively. Bacteriologic culture is seldom helpful and imagery findings are non-specific. The diagnosis is usually made retrospectively based on histologic examination. In women, an intrauterine contraceptive device is often a concomitant factor. Long-term antibiotic treatment (several Months) with high-dose penicillin-based medications is the mainstay of therapy. Despite a high risk of complications, surgery is often necessary both for diagnosis and treatment. Resection or drainage may diminish the dosage and duration of antibiotic therapy, and helps to minimize infectious complications. Actinomycosis should be included in the differential diagnosis of abdominopelvic tumors, inflammatory bowel disease, and endometriosis-particularly in a woman with an intrauterine contraceptive device.
Sergent
F
F
Clinique Gynécologique et Obstétricale, Pavillon Mère-Enfant, Hôpital Charles Nicolle - Rouen. Fabrice.Sergent@chu-rouen.fr
Marpeau
L
L
D018784:Abdominal Abscess / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D015746:Abdominal Pain / Q000382:microbiology; D000196:Actinomycosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004322:Drainage; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007434:Intrauterine Devices / Q000009:adverse effects; D008875:Middle Aged; D010052:Ovariectomy; D034161:Pelvic Infection / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D010538:Peritonitis / Q000382:microbiology; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents