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  • Title: Pelvic actinomycosis following insertion of an intrauterine contraceptive device.
    Author: Gudgeon CW, McCormack DD.
    Journal: Aust N Z J Obstet Gynaecol; 1980 Feb; 20(1):62-4. PubMed ID: 6930254.
    Abstract:
    A case of actinomycosis following insertion of an intrauterine contraceptive device is reported. The patient was treated successfully by antibiotic therapy and conservative surgery. 200 cases of pelvic actinomycosis have been recorded so far, including those which are IUD-related. This paper describes a case of Actinomycosis associated with IUD use. The patient was a 46-year old woman (para 3) who was seen complaining of a 2-week old lower abdominal and pelvic pain and a pelvic mass. She had an IUD inserted 10 weeks before but had it removed 2 weeks prior to referral due to pain and bleeding. Degenerating uterine fibroids was the initial diagnosis, and laparotomy was performed. Biopsy of a segment of the Fallopian tube revealed a lesion which clinically resembled an invasive carcinoma but pathological diagnosis revealed actinomycosis. Penicillin therapy (20 million units daily for 6 weeks and 4 g orally/day for 16 weeks) was instituted and the patient recovered uneventfully. Actinomycosis is a subacute or chronic, usually progressive disease, of orofacial, thoracic or abdominal tissues. Development of infection is associated with trauma, teeth extraction, perforation of hallow viscera, and foreign bodies. Initial diagnoses of this disease usually include tuberculosis, chronic staphylococcal infection, and malignant diseases. Treatment of choice is penicillin given in massive doses over a long period of time, 3 to 6 million units daily for 6 months as advocated by Fisher and Harvey (1956). Antibiotics such as aueromycin (McVay et.al., 1951); chloramphenicol (Littman et.al., 1952); isoniazid (McVay and Sprunt, 1953); oxytetracycline (Lane et.al., 1953); lincomycin (Mahr et.al., 1970); and clindamycin (Rose and Rytel, 1972) have also been used successfully in the management of this disease.
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