PMC5337310_01
CT of pelvis demonstrating multiloculated abscess and dilated bowel loops.
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fig1
Large distended bowel loops surrounded the heterogeneous lesion peripherally (Figure 1).
Sulfur granules from peritoneal aspiration, 40x.
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fig2
Purulent peritoneal fluid was obtained which was negative for malignancy, yet positive for Actinomyces (Figure 2).
Sulfur granules from IUD, 40x.
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fig3
Copper IUD was removed and culture grew Micromonas micros and Actinomyces (Figure 3).
CT of pelvis demonstrating reduction of adnexal mass and decompressed bowel loops at 1 year of treatment.
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fig4
Repeat CT of abdomen and pelvis 1 year after initiation of treatment demonstrated complete resolution of bowel distention, ascites, and adenopathy; the left adnexal mass had more than 50% size reduction, measuring 3.9 x 3.2 cm (Figure 4).