Abstract
Asymptomatic female genital tract colonization with Actinomyces spp is not uncommon, particularly among intrauterine device users. Pelvic actinomycosis is an extremely rare disease. The clinical picture can resemble an advanced ovarian malignancy. We report a case of pelvic actinomycosis mimicking ovarian malignancy diagnosed postoperatively. Preoperative diagnosis is possible if there is a high index of suspicion, obviating extensive surgery and preserving fertility, since long term antibiotic treatment can be completely effective. Pelvic actinomycosis should be included in the differential diagnosis of women presenting a pelvic mass, especially if there is intrauterine device use history.
Highlights
We report a case of pelvic actinomycosis mimicking ovarian malignancy diagnosed postoperatively
Pelvic actinomycosis is a rare, chronic, suppurative and granulomatous disease caused by the anaerobic Gram-positive bacteria Actinomyces spp, most commonly Actinomyces israelii
Despite the association between intrauterine device (IUD) use and pelvic actinomycosis, asymptomatic genital tract colonization by Actinomyces in IUD users must be differentiated from clinically relevant pelvic actinomycotic infection
Summary
Pelvic actinomycosis is a rare, chronic, suppurative and granulomatous disease caused by the anaerobic Gram-positive bacteria Actinomyces spp, most commonly Actinomyces israelii. Actinomyces are commensal organisms that colonize the human oral cavity, gastrointestinal and genital tract.[1] Actinomyces are normally unable to cross the mucosal barrier Tissue injury, such as trauma, surgery, or foreign body, is required for. Loss and lower abdominal pain, sometimes associated with a palpable mass The ability of this disease to mimic pelvic malignancy has been previously presented in several case reports and case series.[2,3] In most cases, the diagnosis of abdominopelvic actinomycosis is only established after exploratory laparotomy for suspected malignancy. Given the infiltrative nature of the mass and the lack of cleavage planes with the nearby structures, and since the patient had no desire of preserving fertility, it was decided to complete total hysterectomy and bilateral salpingo-oophorectomy.
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