Disseminated Pelvic Actinomycosis Presenting as Metastatic Carcinoma: Association with the Progestasert Intrauterine Device

Actinomycosis is caused by the anaerobic bacterium Actinomyces israelii. Asymptomatic colonization of the cervix with this organism has been noted in users of an intrauterine device (IUD), and its prevalence ranges between 1.6% and 36%. Rarely, symptomatic infection may occur, with the potential for...

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Bibliographic Details
Published in:Reviews of infectious diseases 1991-11, Vol.13 (6), p.1115-1119
Main Authors: Jordan H. Perlow, Thomas Wigton, Edgardo L. Yordan, Graham, James, Norman Wool, Wilbanks, George D.
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Muscles - pathology
Abdominal Neoplasms - diagnosis
Abdominal Neoplasms - secondary
Actinomyces
Actinomycosis
Actinomycosis - diagnosis
Actinomycosis - etiology
Adult
Antibiotics
Bacterial diseases
Biological and medical sciences
Birth control
Brain Diseases - diagnosis
Brain Diseases - etiology
Clinical Infectious Disease Articles
Diagnosis, Differential
Electroencephalography
Female
Humans
Infections
Infectious diseases
Intrauterine devices
Intrauterine Devices, Medicated - adverse effects
Lesions
Magnetic Resonance Imaging
Medical sciences
Pelvis
Tomography, X-Ray Computed
Vaginal smears
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Summary:Actinomycosis is caused by the anaerobic bacterium Actinomyces israelii. Asymptomatic colonization of the cervix with this organism has been noted in users of an intrauterine device (IUD), and its prevalence ranges between 1.6% and 36%. Rarely, symptomatic infection may occur, with the potential for extensive morbidity and even death. Herein we report a patient who survived severe disseminated actinomycosis yet presented with the clinical picture of a metastasized malignancy. This is the first report of disseminated pelvic actinomycosis presenting as an external lesion of the abdominal wall and in which a Progestasert IUD (Alza, Palo Alto, CA) was present. The common difficulty, and thus delay, in diagnosing this disease led to considerable morbidity due to an infection considered curable with penicillin. We recommend that all patients with an IUD or a history of IUD use have such information made known to those responsible for interpreting the Papanicolaou smear. Such knowledge may heighten suspicion and focus attention on the identification of these organisms before onset of clinical disease. It is important to consider this disease when caring for patients with an IUD or when counseling those contemplating its use as a contraceptive.
ISSN:0162-0886