Actinomycotic abscesses simulating uterine adnexal tumors: three case reports.

Clinical cases - Pelvic actinomycosis, mostly caused by Actinomyces israeli i is a rare but potentially severe disease. The authors report three cases of pelvic actinomycotic abscesses mimicking malignancy. Clinical symptoms w ere non-specific. asthenia, weight loss, anorexia, pelvic pain, abnormal va ginal bleeding or discharge, and occlusive syndrome. Medical imagery findin gs (ultrasonography and computed tomography) were highly suggestive of canc er. Exploratory laparotomy followed by surgical resection were indicated. T he presence of actinomycotic granules within the abscesses confirmed the di agnosis. In patients 1 and 2, respectively 48 and 44 years of age, the infe ction was related to the use of intrauterine devices (IUD), for more than e ight and five years. This stresses the interest of detecting Actinomyces-li ke organisms in cervical and uterine cytology. Patient 3 was menopausal and used no IUD. Comments - Whatever the patients' age, this opportunistic Infection started in the cervix, spread upwards, causing endometritis, and invaded the uteri ne adnexa. Actinomyces-like organisms could also disseminate via uterine ve ssels (Patient 3). Surgery combined with antibiotherapy (Penicillin) cured the disease. (C) 2001 Editions scientifiques et medicales Elsevier SAS.