Abstract
Background: Pelvic actinomycosis is uncommon and often presents as a complication of an intrauterine device (IUD). A diagnosis of actinomycosis can be made from the finding of sulfur granules within inflammatory exudate on histologic examination after surgery. However, it may be possible to diagnose actinomycosis before surgery by finding Actinomyces-like organisms on Papanicolaou smears.
Case: A 41-year-old woman had been diagnosed as having a pelvic abscess, and bilateral salpingo-oophorectomy was performed. She had been an IUD user for 6 years. Actinomyces-like organisms were detected in her previous Papanicolaou cervical smears. If the patient had been treated when the Actinomyces-like organisms were detected by Papanicolaou smears, the serious ovarian actinomycosis might have been avoided.
Conclusion: We suggest that routine cervical examinations are important for women who are IUD users.
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Selected References
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- Bhagavan B. S., Gupta P. K. Genital actinomycosis and intrauterine contraceptive devices. Cytopathologic diagnosis and clinical significance. Hum Pathol. 1978 Sep;9(5):567–578. doi: 10.1016/s0046-8177(78)80137-3. [DOI] [PubMed] [Google Scholar]
- Burkman R., Schlesselman S., McCaffrey L., Gupta P. K., Spence M. The relationship of genital tract actinomycetes and the development of pelvic inflammatory disease. Am J Obstet Gynecol. 1982 Jul 1;143(5):585–589. doi: 10.1016/0002-9378(82)90552-x. [DOI] [PubMed] [Google Scholar]
- Fiorino A. S. Intrauterine contraceptive device-associated actinomycotic abscess and Actinomyces detection on cervical smear. Obstet Gynecol. 1996 Jan;87(1):142–149. doi: 10.1016/0029-7844(95)00350-9. [DOI] [PubMed] [Google Scholar]
- Hager W. D., Douglas B., Majmudar B., Naib Z. M., Williams O. J., Ramsey C., Thomas J. Pelvic colonization with Actinomyces in women using intrauterine contraceptive devices. Am J Obstet Gynecol. 1979 Nov 1;135(5):680–684. doi: 10.1016/s0002-9378(16)32995-7. [DOI] [PubMed] [Google Scholar]
- Henderson S. R. Pelvic actinomycosis associated with an intrauterine device. Obstet Gynecol. 1973 May;41(5):726–732. [PubMed] [Google Scholar]
- Koshiyama M., Yoshida M., Fujii H., Nanno H., Hayashi M., Tauchi K., Kaji Y. Ovarian actinomycosis complicated by diabetes mellitus simulating an advanced ovarian carcinoma. Eur J Obstet Gynecol Reprod Biol. 1999 Nov;87(1):95–99. doi: 10.1016/s0301-2115(99)00083-4. [DOI] [PubMed] [Google Scholar]
- Lippes J. Pelvic actinomycosis: a review and preliminary look at prevalence. Am J Obstet Gynecol. 1999 Feb;180(2 Pt 1):265–269. doi: 10.1016/s0002-9378(99)70198-5. [DOI] [PubMed] [Google Scholar]
- Müller-Holzner E., Ruth N. R., Abfalter E., Schröcksnadel H., Dapunt O., Martin-Sances L., Nogales F. F. IUD-associated pelvic actinomycosis: a report of five cases. Int J Gynecol Pathol. 1995 Jan;14(1):70–74. doi: 10.1097/00004347-199501000-00012. [DOI] [PubMed] [Google Scholar]
- Schmidt W. A. IUDs, inflammation, and infection: assessment after two decades of IUD use. Hum Pathol. 1982 Oct;13(10):878–881. doi: 10.1016/s0046-8177(82)80046-4. [DOI] [PubMed] [Google Scholar]
- Spence M. R., Gupta P. K., Frost J. K., King T. M. Cytologic detection and clinical significance of Actinomyces israelii in women using intrauterine contraceptive devices. Am J Obstet Gynecol. 1978 Jun 1;131(3):295–298. doi: 10.1016/0002-9378(78)90604-x. [DOI] [PubMed] [Google Scholar]