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Pelvic Actinomycosis


Presentation

  • The IUD had been present for 2 years. The patient presented with an incomplete abortion at 6 weeks' gestation, and the IUD was removed.[ncbi.nlm.nih.gov]
  • This is the first report of disseminated pelvic actinomycosis presenting as an external lesion of the abdominal wall and in which a Progestasert IUD (Alza, Palo Alto, CA) was present.[ncbi.nlm.nih.gov]
  • Abstract We present herein the case of a patient with actinomycosis involving the pelvic cavity, who presented with a rectal stricture.[ncbi.nlm.nih.gov]
  • OBJECTIVE: Pelvic actinomycosis almost always presents as a "dry" type, and pelvic actinomycosis with ascites is extremely rare. We present an unusual case of pelvic actinomycosis with ascites, pleural effusion, and lymphadenopathy.[ncbi.nlm.nih.gov]
  • A case of a pelvic mass in a 49-year-old postmenopausal patient with systemic lupus erythematosus treated with immunosuppressive therapy for two years is presented.[ncbi.nlm.nih.gov]
Fever
  • 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.[ncbi.nlm.nih.gov]
  • fever Roseola or human herpesvirus 6 Rotavirus infection Rubella Salmonellosis Sandfly fever Sarcocystosis Scabies Scarlet fever Schistosomiasis haematobium Schistosomiasis mansoni Septic arthritis Septicemia bacterial Shigellosis Sinusitis Smallpox[books.google.de]
  • After developing a chest infection, she received IV cefotaxime. 7 days later she no longer had a fever, took oral fluids, and was ambulatory.[ncbi.nlm.nih.gov]
  • Author information 1 Leiden University Medical Centre, Department of Medical Microbiology, E4-68, Albinusdreef 2, 2333 ZA Leiden, Netherlands. [email protected] Abstract A female patient presented with episodes of fever and pain in the lower right[ncbi.nlm.nih.gov]
  • CASE: A 30-year-old woman presented with abdominal pain, fever and a pelvic mass. She underwent removal of an intrauterine foreign body, surgical drainage of a tuboovarian abscess and intravenous antibiotic therapy.[ncbi.nlm.nih.gov]
Weight Loss
  • She was admitted to the hospital because of general malaise, weight loss and bilateral palpable adnexal masses. Sonography showed bilateral adnexal masses which contained many echolucent spots.[ncbi.nlm.nih.gov]
  • CASE: A nulliparous woman with a long history of intrauterine contraceptive device (IUD) and recent Papanicolaou smear findings consistent with the presence of actinomyces presented with chronic vague lower abdominal pain, weight loss, poor appetite,[ncbi.nlm.nih.gov]
  • CASE REPORT: A 50-year-old Korean woman presented to our clinic with a 3-month history of abdominal pain and weight loss.[ncbi.nlm.nih.gov]
  • Such a case is presented. a 40-year-old woman experienced lower abdominal pain and a 20 pound weight loss over a 2 month period. The patient had had an IUD (a Dalkon shield) placed 7 years previously and had not sought medical attention since then.[ncbi.nlm.nih.gov]
  • The most common presented symptoms in infected women are abdominal pain, abnormal vaginal discharge, fever, and weight loss.[popline.org]
Malaise
  • She was admitted to the hospital because of general malaise, weight loss and bilateral palpable adnexal masses. Sonography showed bilateral adnexal masses which contained many echolucent spots.[ncbi.nlm.nih.gov]
Chills
  • Spiking fever and chills, intestinal colic, vomiting, and weight loss, a palpable (can be felt) mass and an external sinus are evident in this type of actinomycosis.[healthcentral.com]
Abdominal Pain
  • Three women with intrauterine devices (IUD) each presented with lower abdominal pain and pelvic mass, and elevated white blood cell count and C-reactive protein. Left salpingo-oophorectomy was performed for one the women.[ncbi.nlm.nih.gov]
  • CASE: A 30-year-old woman presented with abdominal pain, fever and a pelvic mass. She underwent removal of an intrauterine foreign body, surgical drainage of a tuboovarian abscess and intravenous antibiotic therapy.[ncbi.nlm.nih.gov]
  • The patient presented with lower abdominal pain to the gynecology clinic and was found to have a pelvic tumor. She had no history of intrauterine device use. Histopathologic examination of the laparotomy specimen revealed pelvic actinomycosis.[ncbi.nlm.nih.gov]
  • The most frequent presenting symptoms were lower abdominal pain and abnormal vaginal bleeding.[ncbi.nlm.nih.gov]
  • It occurred in a 38-year-old Thai female with a history of IUD wearing for 2 years until the symptoms of intermittent lower abdominal pain.[ncbi.nlm.nih.gov]
Pelvic Mass
  • CONCLUSION: Pelvic actinomycosis is an uncommon cause of a pelvic mass.[ncbi.nlm.nih.gov]
  • METHODS: Explorative laparotomy and biopsies of the inflammatory pelvic mass were the only procedures that led to the definitive diagnosis of actinomycosis.[ncbi.nlm.nih.gov]
  • In addition, this group had an increased incidence of abnormal pap smears, which may add a confusing note in the event of a pelvic mass.[ncbi.nlm.nih.gov]
  • Three women with intrauterine devices (IUD) each presented with lower abdominal pain and pelvic mass, and elevated white blood cell count and C-reactive protein. Left salpingo-oophorectomy was performed for one the women.[ncbi.nlm.nih.gov]
Overeating
  • Abstract Actinomycosis of the female genital tract has greatly increased over the last two decades. A pelvic form of the disease, associated with the use of Intra-uterine Devices (IUD), can severely damage pelvic organs and even can lead to death.[ncbi.nlm.nih.gov]
  • We report six patients with pelvic actinomycosis, all of whom had an IUD inserted for over six years. Diagnostic problems necessitated a laparotomy in all patients.[ncbi.nlm.nih.gov]
  • Over the next few weeks the left mass disappeared, but the other mass grew. The physician aspirated hemoserous fluid. They switched to doxycycline over 4 months. 12 months after the initial operation, she had no symptoms and no pelvic abnormalities.[ncbi.nlm.nih.gov]
  • Abstract Three cases of pelvic actinomycosis, which presented over a short period of time, are described. In all three cases the diagnosis was only considered following laparotomy, although there were characteristic diagnostic clues at presentation.[ncbi.nlm.nih.gov]
  • Although the incidence of actinomycosis has decreased, the abdominal-pelvic form has been increasing over the past 10 years secondary to increased prolonged use of the intrauterine device.[ncbi.nlm.nih.gov]
Tenesmus
  • In the last 5 years the patient had been suffering occasionally from pain, abdominal tension and rectal tenesmus. The disease was revealed clearly 18 months after removing the intrauterine device.[ncbi.nlm.nih.gov]
Neglect
  • We report a 50-year-old woman with pelvic actinomycosis resulting from a neglected intrauterine device, which was left in place for 20 years. The signs and symptoms at presentation were consistent with acute peritonitis from a perforated viscus.[ncbi.nlm.nih.gov]
Pelvic Pain
  • The patient is 42-year-old female with a 5 weeks history of pelvic pain. An intrauterine device (IUD) was taken out 3 weeks ago. There is a lump length 9 cm between rectus muscles.[ncbi.nlm.nih.gov]
  • Complications of pelvic actinomycosis include tubal damage resulting in tubal occlusion and infertility, ectopic pregnancy, and chronic pelvic pain.[popline.org]
  • .• Patients present with an indolent history of vaginal discharge, abdominal or pelvic pain, menorrhagia, fever, weight loss, and prolonged use of an intrauterine contraceptive device.DR.T.V.RAO MD 20 21. DIAGNOSIS:.• Gram stain.• Culture.[slideshare.net]
  • If you have symptoms (pelvic pain, discharge, not explained by any other infection) then they can sometimes mean you have to take the coil out (but it's usual to try antibiotics first). But that's it. No hysterectomy.[mumsnet.com]
Adnexal Tenderness
  • She took oral penicillin and probenecid. 2 months later, she suffered lower abdominal and adnexal tenderness. Ultrasound revealed a mass near the left tubal stump and a mass near the right ovary.[ncbi.nlm.nih.gov]
Incontinence
  • CONCLUSIONS: Five years after urinary undiversion, the patient's renal function has been maintained and she can void without incontinence and dysuria.[ncbi.nlm.nih.gov]
Postcoital Bleeding
  • She had a history of postcoital bleeding at 16 weeks' pregnancy and bleeding per vagina during labor at 40 weeks' pregnancy. Speculum examination showed an irregular, friable, easily bleeding mass (3-4 cm in diameter).[ncbi.nlm.nih.gov]

Workup

Elevated Sedimentation Rate
  • Anemia, mild leukocytosis, and an elevated sedimentation rate are relatively common. The pulmonary lesion is either a mass lesion or pneumonitis and may resemble tuberculosis, and blastomycosis. Pleural thickening, effusion, or emphysema are common.[anaerobicinfections.blogspot.com]

Treatment

  • As for antibiotic treatment, it is believed that shorter and high dose antibiotics therapy will be sufficient treatment.[ncbi.nlm.nih.gov]
  • Abstract Case report of tubo-ovarian abscess due to Actinomyces israeli is presented with revision of the literature with regard to pathogenesis, diagnostic difficulties and treatment.[ncbi.nlm.nih.gov]
  • An outpatient treatment strategy would be cost effective and a good choice for patients.[ncbi.nlm.nih.gov]
  • Treatment includes removal of the IUD and administration of penicillin. However at least 1 patient after receiving treatment returned later with actinomycotic tubo-ovarian and subphrenic abscesses.[ncbi.nlm.nih.gov]
  • Standard treatment is long-term antibiotic administration. Here, we report a more radical pelvic abscess drainage treatment, because conservative therapy failed to provide relief.[ncbi.nlm.nih.gov]

Prognosis

  • Other findings: indurated pelvic fat pelvic free fluid pelvic abscess hydronephrosis wider Intra-abdominal extension: mainly through contiguous spread formation of tubo-ovarian abscesses 2 subsequent infertility Treatment and prognosis Treatment is usually[radiopaedia.org]
  • Prognosis relates directly to early diagnosis and is most favorable in the cervicofacial form and progressively worse in the thoracic, abdominal, and generalized forms, especially if the CNS is involved.[merckmanuals.com]
  • Prognosis [ 1 ] Reports of mortality range from 0% to 28% depending on the site of infection, the time to diagnosis and the time to the start of appropriate treatment. The highest mortality occurs in CNS disease.[patient.info]

Etiology

  • We report the first instance of A. naeslundii as an etiological agent of pelvic actinomycosis in a user of an intrauterine device, an infection so far exclusively attributed to Actinomyces israelii.[ncbi.nlm.nih.gov]
  • Four patients had an intrauterine device (IUD) for 6-20 years, three patients had an IUD for 3-5 years, and four patients had no known etiology. In most patients the symptoms lasted from several days to one month.[ncbi.nlm.nih.gov]
  • This paper reviews the etiology and clinical presentation associated with Actinomycosis that often presents as a pelvic mass that mimics a pelvic malignancy.[ncbi.nlm.nih.gov]
  • Actinomycosis: etiology, clinical features, diagnosis, treatment, and management. Infect Drug Resist. 2014;7:183-97. PMid:25045274. 15. Bonnefond S, Catroux M, Melenotte C, et al.[autopsyandcasereports.org]
  • The incidence of this infection is 1:300,000. 1 However, other associated bacterial genera may also be involved in the etiology of this entity, such as Propionibacterium and Bifidobacterium.[revistas.usp.br]

Epidemiology

  • […] actinomycosis, but some sources do not discriminate between actinomycosis of abdomen and pelvis Other common sites are oral cervicofacial actinomycosis ("lumpy jaw", see secondary chronic osteomyelitis ), skin, thoracic and pelvic ( cervix, kidney, ovary ) Epidemiology[pathologyoutlines.com]
  • There is little characteristic epidemiology for actinomycosis in general. Pelvic disease is much more likely when an intrauterine device (IUD) is in place.[infectiousdiseaseadvisor.com]
  • Epidemiology [ 1 ] Actinomycosis is rare.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • […] abdominal actinomycosis comprises 15 - 20% of actinomycosis in humans Males are more commonly affected Sites Most common site is cecum, most often with concurrent ileal disease Some cases are secondary to disease in appendix or female genital tract Pathophysiology[pathologyoutlines.com]
  • PATHOPHYSIOLOGY• In general, Actinomyces species, being members of the normal flora, are agents of low pathogenicity and require disruption of the mucosal barrier to cause disease.[slideshare.net]

Prevention

  • Diligence in replacing IUCDs at recommended intervals and adherence to "missing threads" protocols may prevent these sequelae.[ncbi.nlm.nih.gov]
  • The association of long-term antibiotic treatment is essential to eradicate the infection and prevent relapses.[ncbi.nlm.nih.gov]
  • If a patient presents with symptoms of infection, early diagnosis and aggressive antibiotics may prevent further complications.[ncbi.nlm.nih.gov]
  • Key words: Actinomycosis, acute myeloid leukemia, dysplastic granulocytes, myelodysplastic syndrome Advertisement American Journal of Preventive Medicine and Public Health SUBMIT YOUR ARTICLE NOW[scopemed.org]
  • Abdominal actinomycosis: can early diagnosis prevent extensive surgery? Int J Clin Pract. 2010;64(1):106-9. PMid:20089023. . 24. Ikeda SI, Kato T. A case of pelvic actinomycosis unrelated to an intrauterine device.[autopsyandcasereports.org]

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