Actinomycose pelvienne : aspects diagnostiques et thérapeutiques

Mbarki, Chaouki; Abdelaziz, Ahmed Ben; Sahnoun, R.; Kadhi, Y. El; Douik, F.; Najeh, Hsayaoui; Mezghenni, S; Oueslati, H.

doi:10.1016/j.gyobfe.2016.01.003

Cited by 8 publications

(5 citation statements)

References 26 publications

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“…In clinics, US and plain radiography scan analyses are effective and commonly used techniques. [ 2 , 3 , 7 ] Through US, we could examine the general position and integrity of an IUD. Plain radiography can clearly describe whether an IUD exists in the body, but localizing it is difficult.…”

Section: Discussionmentioning

confidence: 99%

Vesical transmigration of an intrauterine contraceptive device

Chai¹,

Zhang

Jia³

et al. 2017

Medicine

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Rationale:Displacement of an intrauterine contraceptive device (IUD) is a rare and serious complication of IUD insertion. Theoretically, it can migrate to anywhere in the pelvic and abdominal cavity. However, it is not usual for an IUD to migrate to the bladder.Patient concerns:In this case report, we reported a patient with chronic urinary symptoms caused by the migration of an IUD into the bladder. The displacement of the IUD led to contraception failure and IUD retention in the bladder for 5 years.Diagnoses:Pelvic ultrasonography (US), radiography, and cystoscopy examinations confirmed the migration of IUD in bladder.Interventions:The patient underwent cystoscopy.Outcomes:The MCu IUD was successfully removed without any complications.Lessons:Our study demonstrated that a missing IUD should be followed up and removed early to avoid possible serious complications.

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Section: Discussionmentioning

confidence: 99%

Vesical transmigration of an intrauterine contraceptive device

Chai¹,

Zhang

Jia³

et al. 2017

Medicine

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“…However, lower abdominal pain, mass, vaginal discharge, hematuria, fever, leukocytosis, and an elevated erythrocyte sedimentation rate–although non-specific–may raise the suspicion 9 , 10. Imaging methods also lack specificity and cannot distinguish actinomycosis from tumoral, inflammatory, and infectious causes 6. The CT findings of our patient, such as bowel wall thickening and a regional pelvic or peritoneal mass with an extensive infiltration pattern, are common findings in patients with actinomycosis 11…”

Section: Discussionmentioning

confidence: 78%

“…Pelvic actinomycosis is usually associated with the longstanding use of IUDs,6 - 8 and frequently represents a challenging diagnostic task because of the similarity with tuberculosis, malignancy, or other abdominopelvic inflammatory disease 1 , 6 , 7…”

Section: Discussionmentioning

confidence: 99%

“…is not necessarily diagnostic of pelvic actinomycosis. The culture of the IUD or the endometrial biopsies is another diagnostic strategy 6. However, lower abdominal pain, mass, vaginal discharge, hematuria, fever, leukocytosis, and an elevated erythrocyte sedimentation rate–although non-specific–may raise the suspicion 9 , 10.…”

Section: Discussionmentioning

confidence: 99%

“…Actinomyces spp. are very sensitive to oxygen, cultures should be processed within 15 minutes and placed immediately in anaerobic conditions and incubated for a long time to show positive growing (from 5 to 20 days, and up to 76% of the cultures are negative) 2 , 6 , 12 , 13. Gram staining of the pus and the histopathology of the infected tissue are more sensitive than the culture for the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Abdominal and pelvic actinomycosis due to longstanding intrauterine device: a slow and devastating infection

Nakahira

Maximiano

Lima

et al. 2017

ACR

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Actinomycosis is a chronic or subacute bacterial infection characterized by large abscess formation, caused mainly by the gram-positive non-acid-fast, anaerobic, or microaerophilic/capnophilic, obligate parasites bacteria from the Actinomyces genus. Although pelvic inflammatory disease is an entity associated with the longstanding use of intrauterine devices (IUDs), actinomycosis is not one of the most frequent infections associated with IUDs. We present the case of a 43-year-old female patient who was referred to the emergency facility because of a 20-day history of abdominal pain with signs of peritoneal irritation. Imaging exams revealed collections confined to the pelvis, plus the presence of an IUD and evidence of sepsis, which was consistent with diffuse peritonitis.An exploratory laparotomy was undertaken, and a ruptured left tubal abscess was found along with peritonitis, and a huge amount of purulent secretion in the pelvis and abdominal cavity. Extensive lavage of the cavities with saline, a left salpingo-oophorectomy, and drainage of the cavities were performed. The histopathological examination of the surgical specimen revealed an acute salpingitis with abscesses containing sulfur granules. Therefore, the diagnosis of abdominal and pelvic actinomycosis was made. The postoperative outcome was troublesome and complicated with a colocutaneous fistula, which drained through the surgical wound. A second surgical approach was needed, requiring another extensive lavage and drainage of the recto-uterine pouch, plus the performance of a colostomy. Broad-spectrum antibiotics added to ampicillin were the first antimicrobial regimen followed by 4 weeks of amoxicillin during the outpatient follow-up. The patient satisfactorily recovered and is already scheduled for the intestinal transit reconstitution.

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