Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0745411 (irregular bleeding)
 386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 59-year old woman attending the gynecology clinic of the De Soysa Maternity Hospital, Colombo, Sri Lanka, complained of having a brownish vaginal discharge for four years. Initial examination to determine the cause led to a more intense examination conducted under anesthesia, dilation, and curettage. A lippes loop was found in the uterine cavity even though the subject denied practicing contraception and a large amount of yellowish granular material was evacuated. Microbiological analysis confirmed the diagnosis of actinomycosis. This is the first such case to be reported in Sri Lanka. Large doses of intravenous crystalline penicillin were given for two weeks, but symptoms remained. An abdominal hysterectomy and bilateral salpingo-oophorectomy were thus performed after which penicillin administration continued for an additional six weeks. The subject was discharged on tetracycline 500 mg qid for six weeks and was completely cured. Actinomycosis israelii is a gram positive anaerobic filamentous bacterium, a commensal of the gut. Pelvic actinomycosis was until recently considered to be rare and usually caused by a ruptured appendix when it did occur. The organism has recently been associated with IUDs, especially after two years of use, following a route of infection from the anus across the perineum and upwards through the vagina and cervix via the string of the IUD. The combination of a foreign body causing trauma and the adjacent heavy anaerobic flora of the vagina provide ideal conditions for the organism. Clinical manifestations of pelvic actinomycosis are local endometrial infection giving rise to chronic pain, an offensive vaginal discharge, and irregular bleeding per vaginam.
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PMID:Actinomycosis of the uterus. 847 89