RESUMO
The case of a primary ovarian actinomycosis developed during the use of a Szontágh--Szereday type plastic IUD is presented. After a radical operation the patient was discharged in a good condition but 40 days later had to be readmitted because of a pelvic and abdominal wall abscess. After local surgery and massive penicillin treatment she is free of complaints. It is assumed that the IUD had a pathomechanical role.
PIP: A case report of ovarian actinomycosis developed during the use of a plastic IUD describes diagnosis and treatment. After 7 months use of the Szontagh-Szereday IUD, a 33-year-old patient was admitted with fever and a flat tender mass of apple size, reaching to the right pelvic wall. The patient was treated with chloramphenicol, phenylbutazone, trimethoprim and sulphadimidine, erythromycin, neomycin, colistin, and methicillin which were administered in courses of 4-5 days to treat the septic fever and repeated, but negative punctures of the pelvic mass were made. The patient was transfused and then treated with carbenicillin and penicillin and a few complaint-free days followed. On the 65th day of clinical treatment laparoscopy was performed and a mass was found adhering to the pelvic wall and coecum and enclosing the Fallopian tube and ovary. Chronic inflammation with multiple abscesses were seen histologically and total hysterectomy and bilateral adnexectomy were performed. 1 section of the ovary showed a structure suggesting actinomycosis. The patient was discharged and then readmitted on the 40th postoperative day. Culture of an abscess in the right side of the pelvis revealed macrophages, granulocytes, and typical "sulphur" granules. Actinomycosis was diagnosed and treated with penicillin and methicillin.
