Pelvic actinomycosis: a forgotten cause of pelvic pain

Abstract

Actinomycosis is an invasive and suppurative anaerobic infection, which can develop in the pelvis. This occurs most commonly as a result of prolonged use of an intrauterine device. The constellation of signs and symptoms associated with its typical clinical presentation include palpable mass, weight loss and malaise. It can be misdiagnosed as a result and often as a malignant process. Left unrecognised, pelvic actinomycosis can lead to sequelae such as severe abscess, fistula formation and even infertility. Removal of the intrauterine device and a prolonged course (6–12 months) of antibiotic treatment form the cornerstone of management. Surgery can be required in select cases. This article provides an overview of pelvic actinomycosis, including its background, presentation, investigations and management.