Pelvic actinomycosis infection
Patient had episiotomy during normal delivery 2 months ago. presented with infected necrotic wound, vaginal discharge and pelvic pain.
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The uterus is diffusely enlarged with multiple areas within the myometrium of iso-to high signal on T1WI, heterogeneous high signal on T2WI with heterogeneous enhancement mainly peripheral delineating the intramural abscesses. Note the extension of the infection to the anterior vaginal wall.
Minimal effusion is noted in Douglas pouch.
Case of pelvic actinomycosis. Actinomyces spp (Actinomyces israelii in this case) were detected by the cytological examination as well as the bacteriological culture.
Additional contributor: R. Bouguelaa, MD.