Inatomi Ayako, Tsuji Shunichiro, Amano Tsukuru, Kobayashi Masashi
Obstetrics and Gynecology, Kohka Public Hospital, Japan.
Obstetrics and Gynecology, Shiga University of Medical Science, Japan.
J Infect Chemother. 2016 Aug;22(8):567-70. doi: 10.1016/j.jiac.2016.01.017. Epub 2016 Feb 23.
Actinomycosis is a rare chronic suppurative granulomatous infection, associated with long-term IUD placement. Standard treatment is long-term antibiotic administration. Here, we report a more radical pelvic abscess drainage treatment, because conservative therapy failed to provide relief. A 52-year-old woman (gravida 4 para 3) with an 18-year IUD history was referred to our hospital with a pelvic abscess, indicated clinically to be pelvic actinomycosis. Standard conservative penicillin therapy provided no relief. We performed transgluteal drainage, confirmed actinomycosis pathologically, administered clindamycin, and observed no relapse. Transgluteal percutaneous drainage combined with antibiotics may be useful for refractory deep pelvic abscess caused by actinomycosis and may even curtail the antibiotic administration period.
放线菌病是一种罕见的慢性化脓性肉芽肿性感染，与长期放置宫内节育器有关。标准治疗方法是长期使用抗生素。在此，我们报告一种更激进的盆腔脓肿引流治疗方法，因为保守治疗未能缓解病情。一名52岁女性（孕4产3），有18年宫内节育器放置史，因盆腔脓肿被转诊至我院，临床诊断为盆腔放线菌病。标准的青霉素保守治疗无效。我们进行了经臀引流，病理证实为放线菌病，给予克林霉素治疗，未观察到复发。经臀经皮引流联合抗生素可能对放线菌病引起的难治性深部盆腔脓肿有效，甚至可能缩短抗生素使用时间。
