J Bacteriol Virol.  2008 Jun;38(2):89-95. 10.4167/jbv.2008.38.2.89.

Preoperative Diagnosis and Medical Treatment of Pelvic Actinomycosis

• Lee HJ
• Lee SJ
• Kim YJ
• Kim SH
• Lee JH
• Kim SR
• Cho SH

• KMID: 1483978
• DOI: http://doi.org/10.4167/jbv.2008.38.2.89

Abstract

The diagnosis of the pelvic actinomycosis is seldom made preoperatively because of no reliable or specific clinical manifestation which has tendency to mimic advanced gynecological malignancy and the relative infrequency of the disease. To explore the method for improvement of preoperative diagnosis and possibility of avoiding the surgical management of pelvic actinomycosis, we collected and summarized the data of age, parity, state of menopause, history of intrauterine device (IUD) use, symptoms, laboratory findings, radiologic findings, provisional diagnosis and treatment from 14 cases diagnosed pathologically and treated in Hanyang University Hospital from 2000 to 2007. Eleven (78.6%) of 14 cases were IUD users. Most common complaints were lower abdominal pain (71.4%) and vaginal discharge (57.1%) which were followed by fever (28.6%) and back pain (28.6%). Four cases (28.6%) were identified as pelvic actinomycosis before operation and in 3 cases (21.4%) malignancy was provisional preoperative diagnosis. Pelvic actinomycosis was suspected via abdominal computed tomography (CT) or cervicovaginal cytology and confirmed via endometrial biopsy or fine needle aspiration biopsy. Two cases that were diagnosed before operation and received only antibiotics therapy had no recurrence. It was suggested that pelvic actinomycosis could be suspected via abdominal CT and cervicovaginal cytology in IUD users, and endometrial biopsy and fine needle aspiration biopsy may help establish the diagnosis before the operation. Adequate preoperative antibiotics therapy could make extensive exploratory surgery avoided or conservative surgery feasible.

Keyword

Pelvic actinomycosis; Abdominal CT; Cervicovaginal cytology; Endometrial biopsy; Fine needle aspiration biopsy

MeSH Terms

Abdominal Pain
Actinomycosis
Anti-Bacterial Agents
Back Pain
Biopsy
Biopsy, Fine-Needle
Female
Fever
Hydrazines
Intrauterine Devices
Menopause
Parity
Recurrence
Vaginal Discharge
Anti-Bacterial Agents
Hydrazines

Reference

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