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Pelvic actinomycosis three years after colporrhaphy: A case report
Stephen Davick1, Samiksha Annira2, Tyler Schwiesow1
1University of Iowa - Des Moines Internal Medicine Residency Program, 1415 Woodland Ave. Ste. 140, Des Moines, IA 50309, United States.
Abstract:
A 57-year-old patient presented with vaginal discharge and was found to have a pelvic abscess with A. turicensis and Streptococcus constellatus, with likely nidus of infection being a non-absorbable suture placed during colporrhaphy three years prior. She was treated with drain placement and antibiotics. Post-hospitalization, her colporrhaphy suture was removed. Subsequently the drain output decreased and this was removed as well. She had a total course of 6 weeks of amoxicillin/clavulanate, with complete resolution of her abscess.
Insights
A pelvic abscess caused by A. turicensis and S. constellatus was successfully treated by removing a non-absorbable suture and antibiotics. This case highlights the importance of identifying and removing foreign bodies in pelvic abscess treatment.
Area of Science:
- Gynecology
- Infectious Diseases
- Surgical Pathology
Background:
- Pelvic abscesses can arise from various sources, including complications from prior surgical procedures.
- Non-absorbable sutures used in gynecological surgeries can serve as a nidus for chronic infection.
- Polymicrobial infections involving anaerobic and aerobic bacteria are common in pelvic abscesses.
Observation:
- A 57-year-old female presented with vaginal discharge, indicative of a pelvic abscess.
- Imaging revealed a pelvic abscess containing *Actinomyces turicensis* and *Streptococcus constellatus*.
- A non-absorbable suture from a colporrhaphy performed three years prior was identified as the likely source of infection.
Findings:
- The patient was treated with surgical drain placement and a 6-week course of amoxicillin/clavulanate.
- Surgical removal of the non-absorbable suture was performed post-hospitalization.
- Successful resolution of the pelvic abscess was achieved following suture removal and antibiotic therapy, with decreased drain output.
Implications:
- This case underscores the potential for delayed complications from non-absorbable surgical materials in gynecological procedures.
- Early identification and removal of foreign bodies are crucial for effective management of pelvic abscesses.
- A multidisciplinary approach involving surgical and medical management can lead to favorable outcomes in complex pelvic infections.
