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Related Concept Videos

Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Urinary Tract Infection I: Introduction01:26

Urinary Tract Infection I: Introduction

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Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
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Bacterial Phylum Actinobacteria01:30

Bacterial Phylum Actinobacteria

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Coryneform bacteria are gram-positive, aerobic, nonmotile rods that exhibit irregular, club-shaped, or V-shaped arrangements. Their V-shape results from snapping division, where the inner cell wall layer forms the cross-wall, while the outer layer remains intact until it ruptures on one side, causing the daughter cells to bend away.The primary genera are Corynebacterium and Arthrobacter. Corynebacterium includes diverse species, ranging from saprophytes to pathogens like Corynebacterium...
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Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity
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Pelvic actinomycosis: A confusing diagnosis.

Mohamed Aymen Ferjaoui1, Ramzi Arfaoui2, Slim Khedhri1

  • 1Department B of Gynecologic Surgery, Tunis Maternity Center, Tunis Medical School, El Manar University, Tunisia.

International Journal of Surgery Case Reports
|September 10, 2021
PubMed
Summary

Pelvic actinomycosis is a rare infection mimicking gynecologic cancers, often linked to IUD use. Early diagnosis through surgery and antibiotics is crucial for better outcomes and fertility preservation.

Keywords:
ActinomycosisCase seriesGynecologic surgeryIUD contraception

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Area of Science:

  • Gynecology
  • Infectious Diseases
  • Microbiology

Background:

  • Actinomycosis is a rare, chronic, suppurative infection caused by anaerobic Gram-positive bacteria, Actinomyces.
  • Pelvic actinomycosis is exceptionally rare, accounting for 3% of human cases, and often associated with intrauterine device (IUD) contraception.
  • Clinical presentation is non-specific, frequently mimicking gynecologic malignancies or pelvic abscesses, complicating diagnosis.

Purpose of the Study:

  • To describe the clinical characteristics, diagnosis, and management of pelvic actinomycosis.
  • To highlight the diagnostic challenges and potential for misdiagnosis with gynecologic malignancies.
  • To emphasize the importance of accurate diagnosis for patient management and fertility preservation.

Main Methods:

  • Retrospective and descriptive study of twelve patients diagnosed with pelvic actinomycosis.
  • Data collection included patient demographics, IUD history, clinical presentation, diagnostic methods, and management strategies.
  • Analysis focused on clinical suspicion, pre-operative diagnoses, and treatment outcomes.

Main Results:

  • The study included twelve patients with a mean age of 47 years; 75% had a history of IUD use for a mean of 8.44 years.
  • Pelvic pain was the most common symptom. Pre-operative diagnoses included tubo-ovarian abscess (4 cases) and suspected gynecologic malignancies (8 patients).
  • Management involved a combination of surgery and long-term antibiotic administration.

Conclusions:

  • Pelvic actinomycosis is a rare and diagnostically challenging chronic infection.
  • Misdiagnosis can lead to unnecessary surgeries and complications.
  • Accurate and timely diagnosis is essential to reduce morbidity, prevent complications, and preserve fertility.