Bilateral actinomyces abscesses mimicking pelvic malignancy

Abstract

Pelvic actinomycosis is a rare disease caused by Actinomyces israelii [1]. Patients typically present with weakness, weight loss, and pain associated with a unilateral mass [2]. Diagnosis is difficult without surgery and histopathologic examination [2,3]. A 44-year-old woman presented with a 3-month history of lower abdominal pain, nausea, vomiting, weakness, and a 16-kg weight loss. An intrauterine device (IUD) that she had kept for 8 years had been removed 3 months previously. An abdominopelvic examination revealed bilateral adnexal masses. Her hemoglobin level was 10.7 g/dL and white blood cell count 17,200/mm. Her body temperature, blood biochemistry, tumor markers,