Bilateral ovarian actinomycosis masquerading as ovarian malignancy; without any history of intra-uterine contraceptive device

Abstract

Actinomycosis in the pelvic region is an uncommon diagnosis. This infection is caused by Actinomyces israelii, a gram-positive anaerobic saprophyte bacterium that is a normal inhabitant of the upper intestinal tract in humans. Pelvic actinomycosis is difficult to diagnose pre-operatively and is diagnosed, in most cases, accidentally. Actinomycosis can mimic pelvic and abdominal malignancies. A case report of a 35-year-old female patient with a fixed pelvic mass is presented. Despite the broad use of tumor markers, sonography and computerized tomography, the differentiation between benign and malignant pelvic masses is still a clinical challenge. Accurate differential diagnosis is necessary because the treatment strategies vary greatly. A case of actinomycotic inflammatory disease, which was misdiagnosed as an advanced ovarian cancer, is reported.

Keywords

• Actinomycosis
• actinomycotic pelvic inflammatory disease
• intra-uterine device
• intra-uterine device-associated pelvic actinomycosis
• papanicolaou smears
• sulphur granules