Isolated Abdominal Wall Actinomycosis Associated with an Intrauterine Contraceptive Device: A Case Report and Review of the Relevant Literature

Abstract

Isolated abdominal wall actinomycosis in the presence of an intrauterine contraceptive device (IUCD) is extremely rare and only six such cases have been reported in the literature. We report a case where clinical and radiological examinations revealed a pseudotumor within the anterior abdominal wall. After being lost to follow-up, the patient presented two years later with the enlargement of the mass. The mass including the affected anterior abdominal wall was completely excised. The diagnosis of actinomycosis was established postoperatively by histopathological examination. Further questioning concerning her gynecological history revealed long-term use of the same IUCD. Surgical excision of the actinomycotic pseudotumour and removal of the IUCD followed by antibiotic therapy resulted in the full recovery of the patient.

Laparoscopic approach of excision of anterior abdominal wall actinomycosis

“…In cases where significant amount of abdominal wall is removed or aponeurotic involvement is large, mesh placement may be required to prevent hernia in the future. 10 Actinomycotic infections require long term antibiotics up to 6 months. Patients usually respond to oral penicillin, tetracycline, erythromycin, doxycycline and clavulanic acid.…”

Incidental actinomycosis in a 44-year-old female during total abdominal hysterectomy for abnormal uterine bleeding: A case report

“…Actinomycotic pelvic abscesses can mimic malignancies due to their invasive nature, with characteristic sulfur granules observed in draining sinus tracts. 4 , 5 …”