Pelvic actinomycosis: a case report.
BACKGROUND
Pelvic actinomycosis is rare but can manifest with multiple presentations.


METHODS
A 28-year-old woman, gravida 4, para 2, conceived with a Paraguard intrauterine device (IUD) (FEI Products LLC, North Tonawanda, New York) in place. The IUD had been present for 2 years. The patient presented with an incomplete abortion at 6 weeks' gestation, and the IUD was removed. Two and one-half months later the patient presented with signs and symptoms of pelvic inflammatory disease and underwent hospitalization and exploratory laparotomy. The pathology specimen revealed diffuse actinomycosis involving the tube and ovary, appendix, and bowel mucosa. A Pap smear 3 months earlier had revealed Actinomyces.


CONCLUSIONS
Actinomyces has been associated with IUD use and may present even after removal of the IUD. Pelvic actinomycosis is rare, and removal of the IUD may not be adequate treatment. If a patient presents with symptoms of infection, early diagnosis and aggressive antibiotics may prevent further complications.
Dunn
Terry S
TS
Department of Obstetrics and Gynecology, University of Colorado Health Science Center, Denver, Colorado, USA. tdunn@dhha.org
Cothren
Clay
C
Klein
Laura
L
Krammer
Tara
T
D000027:Abortion, Incomplete; D000196:Actinomycosis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D000328:Adult; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D007813:Laparotomy; D010049:Ovarian Diseases / Q000175:diagnosis; D000292:Pelvic Inflammatory Disease / Q000382:microbiology* / Q000628:therapy*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy; D011247:Pregnancy; D012812:Sigmoidoscopy; D014591:Uterine Diseases / Q000175:diagnosis