Džupová Olga, Kulichová Jana, Beneš Jiří
Department of Infectious Diseases, Third Faculty of Medicine, Charles University, 100 00 Prague, Czech Republic.
Department of Infectious Diseases, Hospital Na Bulovce, 100 81 Prague, Czech Republic.
Antibiotics (Basel). 2020 Oct 29;9(11):748. doi: 10.3390/antibiotics9110748.
Actinomycosis is a chronic bacterial infection characterized by continuous local spread, irrespective of anatomical barriers, and granulomatous suppurative inflammation. Due to its expansive local growth, it can simulate a malignant tumour. Subsequent hematogenous dissemination to distant organs can mimic metastases and further increase suspicion for malignancy. A case of severe disseminated pelvic actinomycosis associated with intrauterine device is described here. The patient presented with a pelvic mass mimicking a tumour, bilateral ureteral obstruction, ascites, multinodular involvement of the liver, lungs and spleen, inferior vena cava thrombosis and extreme cachexia. Actinomycosis was diagnosed by liver biopsy and confirmed by culture of from extracted intrauterine contraceptive device (IUD). Prolonged treatment with aminopenicillin and surgery resulted in recovery with moderate sequelae.
放线菌病是一种慢性细菌感染，其特征为持续的局部扩散，不受解剖屏障限制，并伴有肉芽肿性化脓性炎症。由于其局部的扩展性生长，它可能类似恶性肿瘤。随后经血行播散至远处器官可类似转移，进一步增加对恶性肿瘤的怀疑。本文描述了一例与宫内节育器相关的严重播散性盆腔放线菌病病例。患者表现为盆腔肿物，类似肿瘤，双侧输尿管梗阻，腹水，肝脏、肺和脾脏出现多结节受累，下腔静脉血栓形成以及极度消瘦。通过肝活检诊断为放线菌病，并经从取出的宫内节育器培养物证实。使用氨基青霉素进行长期治疗并结合手术，患者康复，但留有中度后遗症。
