[Ovarian abscess due to Actinomyces sp. in absence of an intrauterine contraceptive device]. / Absceso ovárico por Actinomyces sp. en ausencia de un dispositivo intrauterino.

The disease caused by Actinomyces spp. is often of difficult diagnosis. Actinomyces spp. are anaerobic or microaerophilic non-spore-forming gram-positive rods that may reach, occasionally, the normal female genital tract. IUD and pessaries facilitate the access of the microorganisms to the pelvis. We report an unusual case of ovarian infection by Actinomyces sp. in a 41 year-old female without IUD, admitted at the Institute in November 1998, with persistent fever. She had had an early menopause 3 years before, and had received hormonal replacement therapy. Usual and unusual infections were discarded by microbiological and serologic studies. Abdominal ultrasonography showed a slight left pyelocalycial dilatation and a simple cyst in the left ovary; heart ultrasonography was normal. Gynecological examination showed an enlarged uterus, similar to an 8 week pregnancy, painless, and fixed anexial masses. The transvaginal ultrasonography showed uterine myomas, one of them of 42 mm in the isthmus region, large ovaries, cystic, with acoustic shadows, and the left one with a septum. The preoperative diagnosis was infected bilateral cystic teratoma. The procedure was an exploratory laparotomy, followed by a bilateral salpingo-oophorectomy. The specimen studies showed an endometrioma with calcium deposits in the wall of the right ovary, and an abscess in the left ovary, also with calcification of the wall. The sample from the left abscess developed Actinomyces sp. After surgery, and treatment with penicillin, the fever disappeared. It is important to remark that the ovarian infection by Actinomyces sp. can also occur in patients without an IUD or a pessary; it might cause anexial images that can be interpreted as a tumour, inducing to erroneous diagnosis and treatment.

Absceso ovárico por Actinomyces sp. en ausencia de un dispositivo intrauterino. / [Ovarian abscess due to Actinomyces sp. in absence of an intrauterine contraceptive device]

The disease caused by Actinomyces spp. is often of difficult diagnosis. Actinomyces spp. are anaerobic or microaerophilic non-spore-forming gram-positive rods that may reach, occasionally, the normal female genital tract. IUD and pessaries facilitate the access of the microorganisms to the pelvis. We report an unusual case of ovarian infection by Actinomyces sp. in a 41 year-old female without IUD, admitted at the Institute in November 1998, with persistent fever. She had had an early menopause 3 years before, and had received hormonal replacement therapy. Usual and unusual infections were discarded by microbiological and serologic studies. Abdominal ultrasonography showed a slight left pyelocalycial dilatation and a simple cyst in the left ovary; heart ultrasonography was normal. Gynecological examination showed an enlarged uterus, similar to an 8 week pregnancy, painless, and fixed anexial masses. The transvaginal ultrasonography showed uterine myomas, one of them of 42 mm in the isthmus region, large ovaries, cystic, with acoustic shadows, and the left one with a septum. The preoperative diagnosis was infected bilateral cystic teratoma. The procedure was an exploratory laparotomy, followed by a bilateral salpingo-oophorectomy. The specimen studies showed an endometrioma with calcium deposits in the wall of the right ovary, and an abscess in the left ovary, also with calcification of the wall. The sample from the left abscess developed Actinomyces sp. After surgery, and treatment with penicillin, the fever disappeared. It is important to remark that the ovarian infection by Actinomyces sp. can also occur in patients without an IUD or a pessary; it might cause anexial images that can be interpreted as a tumour, inducing to erroneous diagnosis and treatment.

The action of VIRKON No Foam on the hepatitis B virus.

The aim of this work was to verify the in vitro virucidal activity of VIRKON No Foam (VIRKON NF) against the HBV DNA, notoriously one the most resistant viruses to heat and to the most commonly used disinfectants. VIRKON NF, an oxidizing agent, has a synergic effect on nucleic acids, polypeptides, glycoproteins, and structural proteins. The experiment was conducted using the serum of a patient with HBsAg+/HBeAg+/HBVDNA+ with a DNA concentration 100 pg/ml. The virucidal activity was tested using the Slot Blot method, the result being evaluated as an inhibition of the autoradiographic signal because of contact of different concentrated solutions and various contact times with the serum. Preliminary tests were carried out after contact of VIRKON NF with serum solutions at 0.1-0.5-1-4% concentrations for a 15 min contact time. VIRKON NF showed an inhibition of autoradiographic signal equal respectively to 0%, 25-50%, 50-70%, 100%. Further experiments were carried out to compare VIRKON NF virucidal activity on HBV to the activity of the most common disinfectants, such as formic aldehyde, Amuchina, glutaraledhyde and phenol. In this way, the infected serum was put into contact with both the most common disinfectant and 1-1.5-2-3-4% VIRKON NF solutions in contact times of 15, 10, 5, 2 min. Using 3% concentrations for a contact time of 10 min, VIRKON NF showed an autoradiographic inhibition signal of 90%. Regarding other disinfectants, only a 2% glutaraldehyde solution for a contact time of 15 min showed similar virucidal activity.

Evaluation of in vitro efficacy of the disinfectant Virkon.

A study was conducted on a new acid peroxygen system based disinfectant (Virkon), in order to assess its in vitro efficacy. The chemical was tested on different bacteria (Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli), spores (Bacillus subtilis) and on the Hepatitis B surface antigen (HBsAg), and compared in its activity with phenol and glutaraldehyde (calculation of the 'phenol coefficient' and the 'glutaraldehyde coefficient'). The constancy of speed of disinfection, the coefficient of concentration, the minimal inhibitory concentration (MIC) were also determined, and the destruction of the HBsAg antigenic activity was studied using an ELISA kit. The sporicidal efficacy of Virkon was assessed by cultivating spores in agar nutrient after contact with different dilutions of the disinfectant. The results of the tests showed that Virkon has a high concentration coefficient (mean value of k: 0.374/min) and a wide range of action. The low MIC demonstrates how little concentrations of Virkon can inactivate all studied bacteria. The disinfectant was also able to destroy the hepatitis B surface antigen, and it demonstrated good activity against spores, especially if used in physiologic solution. These characteristics, coupled with the absence of initiation or toxic effects on animals showed by other studies, make wide fields of application for the new disinfectant foreseeable.