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Open AccessArticle

Added-Value of Endometrial Biopsy in the Diagnostic and Therapeutic Strategy for Pelvic Actinomycosis

1
Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France
2
Service de Chirurgie générale et gynécologique, Université de Toulouse, CHU de Toulouse, UPS, 31059 Toulouse, France
3
Service d’Anatomie-Pathologie, Université de Toulouse, CHU de Toulouse, 31059 Toulouse, France
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Current affiliation: Hôpital Tenon (APHP.6-Sorbonne), Service de Gynécologie Obstétrique, 75020 Paris, France.
J. Clin. Med. 2020, 9(3), 821; https://doi.org/10.3390/jcm9030821
Received: 2 February 2020 / Revised: 6 March 2020 / Accepted: 14 March 2020 / Published: 18 March 2020
(This article belongs to the Section Obstetrics & Gynecology)
The particularity of pelvic actinomycosis lies in the difficulty of establishing the diagnosis prior to treatment. The objective of this retrospective bicentric study was to evaluate the pertinence and efficacy of the different diagnostic tools used pre- and post-treatment in a cohort of patients with pelvic actinomycosis. The following data were collected: clinical, paraclinical, type of treatment, and the outcome and pertinence of the two diagnostic methods, bacteriological or histopathological, were evaluated. Twenty-seven women were included, with a pre-treatment diagnosis proposed for 66.7% (n = 18) of them. The diagnosis was established in 13.6% (n = 3) of cases through bacteriological samples, and in 93.8% (n = 15) of cases through histopathological samples, with endometrial biopsy positive in 100% of cases. The treatment was surgical with antibiotics for 55.6% (n = 15) of patients, medical with antibiotic therapy for 40.7% (n = 11) of patients, and surgical without antibiotics for one patient. All patients achieved recovery without recurrence, with a median follow-up of 96 days (4–4339 days). Our study suggested an excellent performance of histopathological analysis, and in particular endometrial biopsy, in the diagnosis of pelvic actinomycosis. This tool allowed early diagnosis and, in some cases, the use of antibiotic therapy alone, making it possible to avoid surgery. View Full-Text
Keywords: pelvic actinomycosis; endometrial biopsy; pelvic abscess; intra-uterine device; antibiotics pelvic actinomycosis; endometrial biopsy; pelvic abscess; intra-uterine device; antibiotics
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Carrara, J.; Hervy, B.; Dabi, Y.; Illac, C.; Haddad, B.; Skalli, D.; Miailhe, G.; Vidal, F.; Touboul, C.; Vaysse, C. Added-Value of Endometrial Biopsy in the Diagnostic and Therapeutic Strategy for Pelvic Actinomycosis. J. Clin. Med. 2020, 9, 821.

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