Tubo-ovarian Actinomycosis Complicated with Hepatic Abscess

Abstract

Actinomycosis is a chronic, suppurative, granulomatous diseases characterized by extensive necrosis and abscess formation. Both hepatic and pelvic actinomycosis are rare diseases. Tubo-ovarian actinomycosis complicated with hepatic abscess is rarely reported. We present a 47 year old woman with a history of an intrauterine device (IUD) implantation for about 18 years, who presented with epigastric pain for one month. A computed tomography (CT) scan of abdomen revealed a mass (13×10×9.6 cm) over the left lobe of the liver and a right-sided tubo-ovarian lesion (6.6×5.9 cm). Exploratory laparotomy confirmed liver and tubo-ovarian abscesses. Pathology of the liver and the tubo-ovarian lesions both revealed actinomycosis infection. The patient received a 4-week intravenous ampicillin treatment, followed by oral amoxicillin for 6 months. No recurrence was noted in the follow-up. Actinomycosis should be considered in concomitant liver and ovary abscesses. Detailed history taking, such as IUD implantation, along with radiological examinations and pathological findings are important for diagnosing actinomycosis infection.