Actinomycosis pelvic abscess after in vitro fertilization

Area of Science:

• Reproductive Medicine
• Infectious Diseases
• Gynecologic Surgery

Background:

• Assisted reproductive technology (ART), including in vitro fertilization (IVF), has advanced infertility treatment.
• Pelvic actinomycosis is a rare bacterial infection typically associated with intrauterine devices.
• Tuboovarian abscesses (TOAs) are serious pelvic infections, often polymicrobial.

Observation:

• A 31-year-old woman developed large, multiloculated pelvic and tuboovarian abscesses six days after an IVF cycle for male factor infertility.
• Initial symptoms included urinary retention, pelvic pain, and fever, with persistent pain despite antibiotics.
• Computed tomography (CT)-guided drainage of abscesses was performed.

Findings:

• Culture of drained material confirmed pelvic actinomycosis (Actinomyces israelii) as the cause of the TOAs.
• The patient's symptoms improved following CT-guided drainage and completion of antimicrobial therapy.
• This case highlights pelvic actinomycosis as an infrequent cause of TOA and a rare complication of ART.

Implications:

• Physicians should consider pelvic actinomycosis in patients presenting with fever and pelvic pain post-IVF.
• Prompt diagnosis and management, including abscess drainage and antibiotics, are essential for favorable outcomes.
• This case underscores the importance of recognizing rare infectious complications associated with ART procedures.