[Actinomycosis resembling an ovarian malignancy]

Actinomyces is an uncommon cause of infection which can occur in the lower pelvic area in women using an intrauterine device (IUD). The clinical presentation of actinomycosis can easily be confounded with a malignancy.

In a 53-year-old woman with abdominal pain and fluctuating temperature, ovarian carcinoma was strongly suspected. She underwent a laparotomy in which both adnexae were removed. Histopathological examination of the specimens revealed, however, a rare Actinomyces infection. The patient received long-term antibiotic therapy in the postoperative period, upon which her condition improved.

Differentiation between actinomycosis (mycetoma) and a malignancy is difficult. There are few diagnostic tools to demonstrate an Actinomyces infection, and the diagnosis is therefore often not made until during or after operation. The treatment of actinomycosis consists of long-term administration of antibiotics, although combined surgery and antibiotic therapy is often necessary due to the extent of the infection.