Actinomycosis - an umbrella review and three case reports of severe pelvic actinomycosis treated conservatively
Abstract
Actinomycosis is an uncommon but important chronic or subacute endogenous infection caused by Gram-positive anaerobic (capnophilic) or microaerophilic bacteria, mainly within the Actinomyces genus. Infection can affect all organs of the human body.
The pelvic form in women is the most common in the developed countries and is predominantly associated with the long-standing use of an intrauterine device (IUD). However, IUD removal is not necessary in patients whose uterine cervix tested positive for actinomycetes.
Actinomycosis can mimic other diseases, e.g. a malignancy. the diagnosis is often delayed because actinomycetes grow slowly in culture and other non-culture methods are not entirely reliable. Long-duration treatment with penicillin is completely effective even in cases of severe disease.
Three case reports are presented of severe pelvic actinomycosis in women who wore an IUD for more than five years and whose infection completely cleared up after long-term antibiotic treatment.