Pelvic actinomycosis
Faculty of Sexual & Reproductive Healthcare (FSRH), 2023Garcia-Garcia, 2017Valour, 2014
Pelvic actinomycosis is a rare chronic polymicrobial inflammatory condition in females1 that can mimic pelvic cancer. Pelvic actinomycosis may occur after prolonged intrauterine contraceptive device (IUD) use. Symptoms of pelvic actinomycosis are nonspecific and include pelvic pain, abnormal cervical discharge, abnormal bleeding (either intermenstrual or postcoital) and weight loss.
Female genital tract colonisation with Actinomyces species is not uncommon, and antibiotic treatment or removal of intrauterine contraceptive device (if present) is not required unless there are symptoms of pelvic actinomycosis.
Investigate symptomatic patients by collecting an endocervical swab for Gram stain and culture (including Actinomyces species). Radiological investigations may be indicated depending on the clinical presentation. Treat according to the results of investigations – seek expert advice. Antibiotic therapy for 6 to 12 months and removal of the intrauterine contraceptive device can lead to complete resolution, but surgical intervention may also be necessary.