Adnexal actinomycosis. Association with intrauterine devices

Abstract

We describe the clinical manifestations and the histopathology of four cases of tubo-ovarian Actinornvcosis. Patients were 26, 36:28 and 17 years old with clinical complains of lower abdominal pain, fever, dysuria and polaquiuria. A painful uni or bilateral tubo-ovarian mass was demonstrated on vaginal or rectal examination in all cases. Mild anemia, leukocytosis with neutrophilia and high sedimentation rate, was usual on laboratory evaluation. Cultures for the bacteria were negative or none done. The surgically removed tubo ovarian masses showed multiple abscess with yellowish dense purulent material surrounded by a dense fibrous capsule. Histologically, multiple filament bacterial granules, centrally basophilic, and with peripheral eosinophilic club like structures radiating from it, were observed within the neutrophilic and eosinophilic inflammatory cell exudation. Base on the granules and the bacterial morphology, the speciphic diagnosis was proposed, the treatment oriented, and the evolution was successful.