Ovarian actinomycosis in absence of intrauterine contraceptive device: an unusual presentation
Marwah, S.; Marwah, N.; Singh, I.; Singh, S.; Gupta, A.; Jaiswal, T.S.
Acta Obstetricia et Gynecologica Scandinavica 84(6): 602-603
2005
ISSN/ISBN: 0001-6349 PMID: 15901274 DOI: 10.1080/j.0001-6349.2005.0037a.xDocument Number: 254086
A 35-year-old woman was admitted to hospital with a 15-day history of lower abdominal pain associated with fever and vomiting of 7 days duration [Haryana, India]. On examination, there was a mass palpable in the right iliac fossa along with tenderness and muscle rigidity. Ultrasonography showed a hypoechoic area (5.3x5.1 cm in size) in the right lumbar region and a hetroechoic area (5.3x4.9 cm in size) in the right pelvis. A clinical diagnosis of appendicular lump was made and she was treated with intravenous fluids, antibiotics and analgesics. After 6 days of nonresponse to treatment, exploratory laparotomy was performed, which revealed a right tuboovarian mass with abscess extending to the paracolic gutter and parietal wall. A left ovarian cyst was also observed. Right salpingectomy was performed in addition to drainage of the parietal wall abscess. Histopathological examination revealed a tuboovarian abscess with actinomycotic colony and reactive hyperplasia of mesenteric lymph nodes. The postoperative period was uneventful.