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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

200 cases of pelvic actinomycosis have been recorded so far, including those which are IUD-related. This paper describes a case of Actinomycosis associated with IUD use. The patient was a 46-year old woman (para 3) who was seen complaining of a 2-week old lower abdominal and pelvic pain and a pelvic mass. She had an IUD inserted 10 weeks before but had it removed 2 weeks prior to referral due to pain and bleeding. Degenerating uterine fibroids was the initial diagnosis, and laparotomy was performed. Biopsy of a segment of the Fallopian tube revealed a lesion which clinically resembled an invasive carcinoma but pathological diagnosis revealed actinomycosis. Penicillin therapy (20 million units daily for 6 weeks and 4 g orally/day for 16 weeks) was instituted and the patient recovered uneventfully. Actinomycosis is a subacute or chronic, usually progressive disease, of orofacial, thoracic or abdominal tissues. Development of infection is associated with trauma, teeth extraction, perforation of hallow viscera, and foreign bodies. Initial diagnoses of this disease usually include tuberculosis, chronic staphylococcal infection, and malignant diseases. Treatment of choice is penicillin given in massive doses over a long period of time, 3 to 6 million units daily for 6 months as advocated by Fisher and Harvey (1956). Antibiotics such as aueromycin (McVay et.al., 1951); chloramphenicol (Littman et.al., 1952); isoniazid (McVay and Sprunt, 1953); oxytetracycline (Lane et.al., 1953); lincomycin (Mahr et.al., 1970); and clindamycin (Rose and Rytel, 1972) have also been used successfully in the management of this disease.
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PMID:Pelvic actinomycosis following insertion of an intrauterine contraceptive device. 693 Feb 54

In the last 10 years, several cases of pelvic actinomycosis have been reported in women using an IUD. 1 such case of a 35-year-old white woman, gravida 2, para 2, is reported. The woman had been using a Dalkon Shield for over 7 years. Exploratory laparotomy revealed bilateral tubo-ovarian abscesses and bilateral therapeutic salpingo-oophorectomy was performed. Although the abscess wall revealed "sulfur granules" characteristic of actinomycosis infection, the cultures were negative. The presumptive diagnosis remains actinomycosis based on the finding of sulfur granules. It is felt that IUDs predispose to actinomycosis colonization by causing chronic trauma to the endometrium, resulting in a mass of necrotic tissue which serves as a culture medium for the organism. The problem has been noted with both metallic and plastic IUDs. Most of the severe cases have occurred in women using an IUD for more than 3 years. It is not known whether the actinomycosis is the major pathogen or whether it causes changes in the pelvic tissue predisposing to additional organisms. Symptoms of actinomycosis are: pelvic pain, purulent discharge, bleeding, and fever. Signs include pelvic tenderness and a pelvic mass. There can, however, be severe infection with only minimal symptoms. Treatment includes both surgery to drain the abscess and antibiotic therapy.
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PMID:Pelvis actinomycosis associated with intrauterine contraceptive devices. 727 44

A case of association between IUD and a left tubal actinomycotic abscess is presented. The 45 year old patient was wearing an IUD for five years. The symptomatology was mainly that of pelvic pain with an associated mass in the left iliac fossa. The working diagnosis was that of a digestive tumor or an adnexal mass. The surgical procedure allowed to identify an inflammatory reaction with a pseudotumoral abscess formation in the left fallopian tube. The etiology was confirmed by the pathology and bacteriology reports. Treatment consists in surgical extirpation of the infected structures and long term antibacterial therapy. Actinomycosis is a rare but potentially serious pelvic disease. It may involve various organs and readily takes on the aspect of tumor formation.
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PMID:[Pelvic actinomycosis abscess and intrauterine device]. 915 13

The purpose of this report is to describe the case of a 35-year-old patient admitted to the National Oncology Institute in Rabat, Morocco for pelvic pain and deteriorating general status ongoing for 8 months. Clinical and ultrasonographic examination showed a heterogenous mass measuring 7 cm in maximum width located inferior and lateral to the inferior aspect of the right side of the uterus. These findings were suggestive of a malignant tumor of the right ovary. Ovariectomy and omentectomy were performed. Histological examination of surgical specimens demonstrated right tubo-ovarian actinomycosis associated with peritonitis. Genital tract actinomycosis is an uncommon finding in women of childbearing age. It is due to colonization by a pyogenic bacteria (Actinomyces) usually secondary to a gastrointestinal infection, e.g. ileocecum, and sometimes in association with the presence of an intrauterine device or foreign body. Based on this case report, the authors discuss abdominopelvic actinomyocosis with emphasis on tumor-like findings that can lead to misdiagnosis by clinicians and radiologists.
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PMID:[Pelvic actinomycosis simulating adnexal malignant tumor]. 1203 84

An interesting case of pelvic actinomycosis with paculiar clinical manifestation is presented. A 42 years-old patient came to our emergency service for an abdominal pelvic pain and fever. Past history showed IUD in situ for over 15 years. The patient was submitted to a ultrasonographic scan and a complete hematological screening was performed. The diagnosis was of subacute abdomen, and an exploratory laparotomy was carried out. During laparotomy an atypical reactive tissue and a suppurative cavity were found. The histological finding of tissue biopsy showed pelvic actinomycosis. On the basis of these findings the conclusion is drawn that a better prevention of pelvic actinomycosis is necessary of its diffusion in the last years due to sexual habit changes.
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PMID:[Pelvic actinomycosis and sub-acute abdomen]. 1243 34

Tubo-ovarian actinomycosis is a rare location for infection by actinomyces. Only around 50 cases have been described in the world literature since 1963. Diagnosis can be difficult due to the highly misleading solid pseudotumoral appearance of this infection. The purpose of this report is to describe the case of a 40-year-old patient with an intrauterine device who presented abdomino-pelvic pain associated with guarding in the right iliac fossa. Pelvic ultrasound revealed an ovarian mass. Histological examination of the surgical specimen after annexectomy demonstrated tubo-ovarian actinomycosis. Based on this case involving a rare clinical form of the actinomycosis, we review the various clinical aspects of this infection and underline the importance of histology in achieving diagnosis. We also provide a general review of the literature.
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PMID:[Solid pseudotumoral tubo-ovarian actinomycosis. A case report in Morocco]. 1868 23

Actinomycosis is a rare suppurative disease due to Actinomyces species. These Gram-positive, non-acid fast anaerobic filamentous bacteria are normal inhabitants of the human body, tending to reside in the oropharynx and bowel but are occasionally found in the vagina. Pelvic actinomycosis is a rare bacterial disease in women. Clinical manifestations are various and non specific and may be acute or chronic. No consensus exists for treatment. We reviewed files and identified all five cases of pelvic actinomycosis managed at Obstetrics and Gynaecology department "A" at the Maternity Center of Tunis over an eight-year period (1998-2005). The women's average age was 39.2 years. One patient was menopausal and consulted for bleeding. The other four patients were younger and had all been using an intrauterine device (IUD) for contraception. They presented with acute clinical manifestations. Their main symptom was pelvic pain. Three women had fever, and two presented with urinary tract obstruction. All patients had surgery. A pelvic abscess was found in four cases. Laparoscopic management was possible in only one case. Laparotomy was necessary in the other four. Four women had adnexectomies, two with hysterectomy. Digestive complications occurred in three cases. Actinomycosis was diagnosed only after surgery, by the histological examination. This series confirms the difficulties encountered in the management of pelvic actinomycosis. We review the recent literature and describe the diagnostic and therapeutic procedures currently recommended. The relationship between pelvic actinomycosis and IUDs, the most common method of contraception in Tunisia, is clearly established. Clinical diagnosis of pelvic actinomycosis is difficult because the symptoms are non-specific. Laboratory tests can help by showing serious inflammation, however. Imaging findings are also non-specific and may suggest an abscess or an inflammatory or neoplastic process. Interventional radiology, specifically CT- or ultrasound-guided aspiration biopsy can facilitate diagnosis, which in any case requires a histological examination. Treatment of pelvic actinomycosis is not standardized and depends on clinical form. Medical treatment is based on long-term penicillin G. It is always necessary and may be used alone in cases of preoperative diagnosis. Surgery should be offered only in resistant cases and should always be followed by long-term antibiotic treatment. The prognosis of correctly treated pelvic actinomycosis is generally good.
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PMID:[Pelvic actinomycosis in Tunisia: five cases]. 1918 30

A case of pelvic actinomycosis is presented. 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. Ultrasound, magnetic resonance imaging (MRI) and histology are used to make the diagnosis. Actinomycosis can mimic the tumour disease. The definitive diagnosis requires positive anaerobic culture or histological identification of actinomyces granulas. A long lasting antibiotic therapy is performed.
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PMID:Case report: pelvic actinomycosis. 2237 4

We present super infection of an ovarian dermoid cyst with actinomyces in an infertile patient. This is a case-report study for evaluation a couple with male factor infertility, who was a good candidate for intracytoplasmic sperm injection (ICSI), while a 10 cm dermoid cyst was found in the woman's right ovary. Patient complained of pelvic pain, intermittent fever, dysmenorrhea, and dyspareunia. The cyst was extracted using laparoscopy, whilst in histopathological examination, an actinomycosis super infection was reported. Actinomyc super infection of an ovarian dermoid cyst is a very rare incident which can also occur in women with no history of intrauterine device (IUD) usage or previous fertility.
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PMID:Super infection of an ovarian dermoid cyst with actinomyces in an infertile woman. 2452 Apr 76