Pelvic Actinomycosis Associated with an Intrauterine Device

Abstract

Female genitalia are relatively rare sites for pelvic actinomycosis. Pelvic actinomycosis is further unsuspected, as actinomyces do not inhabit the vaginal canal. Adenexal involvement can occur secondary to infection in the gastrointestinal canal. Currently, the use of an intrauterine contraceptive device (IUCD) is an important cause of ascending infection. In this paper, we report a case of pelvic actinomycosis associated with the use of an IUCD. Since signs and symptoms are nonspecific, a high degree of suspicion is necessary for a diagnosis. When a mass or an abscess is found in the pelvis in patients with IUCDs, fevers, and laboratory findings that indicate presence of infections, a pelvic actinomycosis should be considered. A diagnosis can be confirmed by culture and histopathology; however, the radiologist can assist in making the diagnosis with a computed tomography scan or an ultrasound-guided aspiration biopsy.