title: [Pelvic actinomycosis: Diagnostic and therapeutic aspects].
abstract: OBJECTIVE
  Actinomycosis is a rare little known granulomatous suppurative disease, more common in women, aided by the use of contraceptive purposes intrauterine device (IUD). Pelvic location is the rarest with an extension to adjacent organs making preoperative diagnosis difficult and misleading clinical presentation. Early diagnosis of this affection determines the therapeutic strategy and avoids mutilating interventions especially in young women.
  
  
  METHODS
  We reviewed the record of women who consulted the department of obstetrics and gynecology at Ben Arous hospital (Tunisia) between January 2003 and December 2013 for a pelvic pain syndrome and in whom diagnosis of actinomycosis was suspected by clinical and imaging and confirmed by pathology.
  
  
  RESULTS
  Eight cases of gynecologic abdominopelvic actinomycosis were diagnosed during the study period. Seven patients were carriers of an intrauterine device, with an average duration of 5 years wearing. Functional signs were essentially pelvic pain and fever. Physical examination of patients mainly showed two clinical presentations: a pelvic tumor syndrome or abdominopelvic and an array of pelvic abscess or pelvic inflammatory disease. Radiological investigations were allowed to suspect the diagnosis of actinomycosis only in one patient, in whom percutaneous biopsy confirmed the histological diagnosis without resorting to a surgical procedure. Operative procedures performed were varied as appropriate. The diagnosis of actinomycosis was made by pathology without any cases of bacterial isolation. All patients received antibiotic treatment with penicillin. The subsequent evolution was favorable.
  
  
  CONCLUSIONS
  The diagnosis of actinomycosis should be considered in any invasive abdominal mass of neoplastic appearance and in case of table of genital infection especially in patients bearing IUD for 5 years or more.
authors: Service de gynécologie obstétrique, hôpital de Ben Arous-Yesminette, Ben Arous, Tunisie. Electronic address: chabmbarki@yahoo.fr.
authors: C
authors: C
authors: Mbarki
authors: Service de gynécologie obstétrique, hôpital de Ben Arous-Yesminette, Ben Arous, Tunisie.
authors: A
authors: A
authors: Ben Abdelaziz
authors: Service de gynécologie obstétrique, hôpital de Ben Arous-Yesminette, Ben Arous, Tunisie.
authors: R
authors: R
authors: Sahnoun
authors: Service de gynécologie obstétrique, hôpital de Ben Arous-Yesminette, Ben Arous, Tunisie.
authors: Y
authors: Y
authors: El Kadhi
authors: Service de gynécologie obstétrique, hôpital de Ben Arous-Yesminette, Ben Arous, Tunisie.
authors: F
authors: F
authors: Douik
authors: Service de gynécologie obstétrique, hôpital de Ben Arous-Yesminette, Ben Arous, Tunisie.
authors: N
authors: N
authors: Hsayaoui
authors: Service de radiologie, hôpital de Ben Arous-Yesminette, Ben Arous, Tunisie.
authors: S
authors: S
authors: Mezghenni
authors: Service de gynécologie obstétrique, hôpital de Ben Arous-Yesminette, Ben Arous, Tunisie.
authors: H
authors: H
authors: Oueslati
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects; D034161:Pelvic Infection / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology*; D017699:Pelvic Pain; D010406:Penicillins / Q000627:therapeutic use; D014416:Tunisia
chemical_list: D010406:Penicillins
keywords: Actinomycose; Actinomycosis; Adnexal tumor; Diagnostic; Diagnostics; Dispositif intra-utérin; Intrauterine device; Pathology; Pelvis; Traitement; Treatment; Tumeur annexielle