Unavoidable surgical intervention in two women with severe actinomycosis during IUD use
Bergenhenegouwen, L.A.; de Haan, H.H.; Sijbrandij, E.S.; Groeneveld, P.H.
Nederlands Tijdschrift Voor Geneeskunde 147(48): 2382-2385
2003
ISSN/ISBN: 0028-2162 PMID: 14677481 Document Number: 237883
Extensive abdominal infections with Actinomyces were diagnosed in two women aged 35 and 33 years respectively, who suffered from the nonspecific symptoms fever and abdominal pain. These infections occur more often in women with an intrauterine device. Development of an abdominal mass with ureter or bowel obstruction may cause hydronephrosis and mechanical ileus. The patients underwent a laparotomy and a double-J catheter was inserted, which could be removed later on (temporary stoma). Treatment included high-dose penicillin i.v. followed by oral amoxicillin. Both patients recovered. It may be difficult to establish this diagnosis: the first patient was diagnosed by histopathological examination, in the second Actinomyces had been found in a routine cervical smear a few years earlier.