[Pelvic actinomycosis: a case with secondary localization in the liver]. / Actinomycose pelvienne: un cas avec localisation secondaire hépatique.

BACKGROUND: Actinomycosis is uncommonly observed in a pelvic localization. The presence of an intrauterine device is an important risk factor. CASE REPORT: A 50-year-old woman presented a tumoral mass in the pelvis with secondary liver involvement. Pathology examination corrected the initial diagnosis of advanced stage pelvic neoplasia to actinomycosis. Rapid improvement was achieved with penicillin. DISCUSSION: Differential diagnosis is difficult but essential in case of pelvic actinomycosis as misdiagnosis can have disastrous surgical consequences. Medical treatment is indicated. Actinomycosis should be entertained as a possible diagnosis in all cases associating a pelvic tumor and inflammation in women wearing an intrauterine device.

[Pelvic actinomycosis]. / Actinomycose pelvienne.

UNLABELLED: AN UNUSUAL INFECTION: Actinomycosis, uncommon in a pelvic localization, is a severe condition not well known to gynecologists. It is caused by Actinomyces israeli and is closely associated with long-term use of an intrauterine device. In the pelvic localization, the disease generally presents as a pseudoneoplastic formation. DIFFICULT DIAGNOSIS: Diagnosis is generally not established clinically. Pathology provides positive diagnosis. The germ cannot be isolated easily as it does not survive standard bacteriology sampling. Monoclonal antibodies may be helpful. MEDICAL TREATMENT: Intravenous penicillin G followed by at least 6 months oral penicillin is generally successful in eradicating the infection. Indications for surgery should be limited to diagnostic procedures (pathology specimen), drainage in case of abscess formation, and removal of an obstacle compressing the digestive or urinary tract.