Abstract
Pelvic actinomycosis comprises a rare, subacute to chronic bacterial infection characterised by suppurative and granulomatous inflammation. Diagnosis is difficult as it may simulate pelvic malignancies. Laboratory and radiological findings are non-specific. We reported on 2 cases of pelvic actinomycosis mimicking ovarian malignancy with different management approaches that lead to opposite outcomes. We reviewed the literature on pelvic actinomycosis imitating ovarian cancer with a focus on its surgical management. Despite agreement on the duration of antibiotic therapy following surgical management, consensus regarding surgical approach was rather equivocal. We concluded that pelvic actinomycosis should be strongly suspected in women with presumed ovarian cancer of atypical presentation and a history of intrauterine devices (IUD).Electronic supplementary materialThe online version of this article (doi:10.1186/2053-6844-1-5) contains supplementary material, which is available to authorized users.
Highlights
Actinomycosis comprises a subacute to chronic bacterial infection caused by filamentous, gram-positive, nonacidfast, anaerobic bacteria
We presented 2 case reports of pelvic actinomycosis with different management approaches that lead to opposite outcomes
Studies referred to bladder cancer, intrauterine myomas and tubo-ovarian abscesses respectively and one study was on a pediatric patient
Summary
Actinomycosis comprises a subacute to chronic bacterial infection caused by filamentous, gram-positive, nonacidfast, anaerobic bacteria. Case report 1 A 57-year old, mother of two, postmenopausal caucasian woman was referred to our centre following MDT discussion for a 4-month long, persistent, progressively worsening lower abdominal pain This was associated with mild, offensive vaginal discharge but no vaginal bleeding. Following initial laparoscopic assessment to assess the disease operability, she underwent an en bloc pelvic resection with total abdominal hysterectomy and bilateral salpingo-ophorectomy, omentectomy, bladder peritonectomy, rectosigmoid resection with re-anastomosis and excision of an anterior abdominal wall tumour. Case report 2 A 37-year old, mother of two, caucasian woman was initially presented to the gastroenterology team for investigation of a 3-month long persistent, progressively worsening lower abdominal pain This was severe in nature, predominant in the left flank, lasting for a few seconds and spontaneously resolving. She returned to follow-up appointments at 6 weeks and 6 months and was completely asymptomatic
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