Predictors associated with severity of pelvic actinomycosis

Abstract

To evaluate the clinical features of pelvic actinomycosis and to identify predictive factors associated with severity of pelvic actinomycosis. Medical records of 25 patients diagnosed with pelvic actinomycosis and treated by surgery between September 1994 and March 2010 at Cheil General Hospital and Women's Healthcare Center were reviewed retrospectively. Of the 25 patients, 15 (60%) had mild pelvic actinomycosis with adhesion and abscess but no complications. The other 10 patients (40%) had an aggressive state of pelvic actinomycosis accompanied by diverse complications, such as hydroureter, abscess rupture, bowel obstruction and cystoenteric fistula. The aggressive actinomycosis correlated with fever, higher neutrophil percentage and a higher white blood cell count to hemoglobin ratio compared to those with mild pelvic actinomycosis. However, there were no significant differences in the use of intrauterine devices, C-reactive peptide level or mass size between those with mild and aggressive pelvic actinomycosis. Using the clinical factors, such as fever, neutrophil percentage and white blood cell count to hemoglobin ratio, the surgeons can more accurately predict the severity of pelvic actinomycosis, thus being helpful for more proper disease management.