An unusual presentation of actinomycosis in a young woman, after surgery

Actinomycosis is an unusual, chronic granulomatous disease. Actinomyces israelli has been found to be related to infectious processes in those patients with affected skin integrity leading to abscess formation, fistulae or mass lesions. Actinomycosis mainly presents in three forms cervicofacial (50%), abdominal (20%) and thoracic (15%). Pelvic cases have been rarely reported and are usually associated with the use of intrauterine devices. We describe a case of a 23 y/o female without history of intrauterine device use, who was admitted with an ovarian cyst following an appendectomy. An ovarian abscess was drained. The pathology showed a granuloma and focal sulfur granules like particles compatible with Actinomyces. This is a case of pelvic Actinomyces, not related to the use of an intrauterine device

Results of Pap smear examinations in women with abnormal ovaries.

Using the VCE technique, the Pap smears of 249 women with abnormal ovaries were examined at the Cytological Laboratory, Siriraj Hospital. The cases, ranging in age from 15 to 85 years (the mean age being 42.1 +/- 14.7 years), were diagnosed as follows: 49 cases with cysts, 89 cases with tumours and 111 cases with cancer. The mean ages of the women with cysts, tumours and cancer of the ovaries were 34.0 +/- 8.6, 37.2 +/- 12.8 and 49.5 +/- 14.8 years, respectively. The percentages of women with cysts, tumours and cancer diagnosed cytologically as having a normal smear were 44.9, 28.1 and 23.4; and infection and inflammation of abnormal ovaries 49.0, 49.4 and 41.5, respectively. The percentages of those with abnormal cells at the uterine cervix were 6.1, 21.4, and 31.5; endometrial adenocarcinoma 0, 1.1 and 0; and ovarian adenocarcinoma 0, 0 and 3.6, respectively. Although Pap smear examination using the VCE technique is sensitive in the early detection of cervical cancer, it is not a sensitive method in the detection of ovarian cancer.