title: Actinomyces bacteremia in association with tubo-ovarian abscesses and hysteroscopic sterilization.
abstract: BACKGROUND
  Actinomyces infection is well-documented in intrauterine devices but has not been previously associated with hysteroscopic sterilization using coil inserts. Additionally, abscesses associated with these implants have been observed in few cases.
  
  
  METHODS
  A 31-year-old multiparous woman with a history of hysteroscopic sterilization with coil inserts 18 months previously presented with several weeks of pelvic pain. Despite percutaneous drainage of intra-abdominal abscesses, her pain and fevers persisted. Blood cultures were positive for Actinomyces infection, and exploratory laparotomy demonstrated abscesses at both coil sites.
  
  
  CONCLUSIONS
  When a causative organism cannot be identified or the when patient does not respond to standard antibiotic therapy, Actinomyces infection should be considered because prolonged antibiotic therapy is necessary.
authors.affiliation: Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
authors.forename: Janelle B
authors.initials: JB
authors.lastname: Pakish
authors.forename: Loyd
authors.initials: L
authors.lastname: West
mesh_terms: D000038:Abscess / Q000150:complications* / Q000382:microbiology; D000190:Actinomyces / Q000302:isolation & purification / Q000472:pathogenicity*; D000196:Actinomycosis / Q000382:microbiology; D000291:Adnexal Diseases / Q000150:complications* / Q000382:microbiology; D000328:Adult; D016470:Bacteremia / Q000382:microbiology*; D005260:Female; D006192:Haemophilus Infections / Q000150:complications* / Q000382:microbiology; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D015907:Hysteroscopy; D011183:Postoperative Complications / Q000382:microbiology*; D013246:Sterilization, Tubal / Q000009:adverse effects* / Q000295:instrumentation