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Pelvic Actinomycosis
Alejandra García-García1, Ninfa Ramírez-Durán1, Horacio Sandoval-Trujillo2
1Laboratory of Medical and Environmental Microbiology, Department of Medicine, Autonomous University of the State of Mexico, 50180 Toluca, MEX, Mexico.
Introduction:
Actinomycosis is a chronic bacterial infection caused by Actinomyces, Gram-positive anaerobic bacteria. Its symptomatology imitates some malignant pelvic tumours, tuberculosis, or nocardiosis, causing abscesses and fistulas. Actinomycoses are opportunistic infections and require normal mucous barriers to be altered. No epidemiological studies have been conducted to determine prevalence or incidence of such infections.
Objective:
To analyse the clinical cases of pelvic actinomycosis reported worldwide, to update the information about the disease.
Methods:
A systematic review of worldwide pelvic actinomycosis cases between 1980 and 2014 was performed, utilising the PubMed, Scopus, and Google Scholar databases. The following information was analysed: year, country, type of study, number of cases, use of intrauterine device (IUD), final and initial diagnosis, and method of diagnosis.
Results:
63 articles met the search criteria, of which 55 reported clinical cases and 8 reported cross-sectional studies.
Conclusions:
Pelvic actinomycosis is confusing to diagnose and should be considered in the differential diagnosis of pelvic chronic inflammatory lesions. It is commonly diagnosed through a histological report, obtained after a surgery subsequent to an erroneous initial diagnosis. A bacterial culture in anaerobic medium could be useful for the diagnosis but requires a controlled technique and should be performed using specialised equipment.
Insights
Pelvic actinomycosis, a chronic bacterial infection, often mimics other serious conditions, leading to delayed diagnosis. Early consideration in differential diagnoses is crucial for effective management.
Area of Science:
- Gynecology
- Infectious Diseases
- Microbiology
Background:
- Actinomycosis is a chronic bacterial infection caused by *Actinomyces*.
- It presents with symptoms mimicking pelvic tumors, tuberculosis, or nocardiosis, leading to abscesses and fistulas.
- This opportunistic infection requires altered mucous barriers and lacks epidemiological data on prevalence and incidence.
Purpose of the Study:
- To systematically review and update information on pelvic actinomycosis cases globally.
- To analyze clinical presentations, diagnostic methods, and outcomes of pelvic actinomycosis.
Main Methods:
- A systematic review of worldwide pelvic actinomycosis cases from 1980 to 2014.
- Literature search conducted using PubMed, Scopus, and Google Scholar.
- Analysis of case reports focusing on diagnosis, IUD use, and treatment.
Main Results:
- 63 articles were identified, including 55 case reports and 8 cross-sectional studies.
- Data on year, country, IUD use, initial/final diagnoses, and diagnostic methods were analyzed.
Conclusions:
- Pelvic actinomycosis presents diagnostic challenges and should be included in the differential diagnosis of chronic pelvic inflammatory lesions.
- Histological reports, often post-surgery, are common for diagnosis due to initial misdiagnosis.
- Bacterial culture in anaerobic medium is a potential diagnostic tool but requires specialized techniques and equipment.
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