[Radiological abnormalities and long-term IUD use: think of actinomycosis]. / Intra-abdominale massa's en een intra-uterien device.

BACKGROUND: A rare cause of nonspecific, chronic abdominal pain is actinomycosis. Extensive disease can cause chronic peritonitis mimicking malignancy. CASE DESCRIPTION: A 59-year-old women presented with aspecific chronic abdominal pain, after 23 years of IUD use. Imaging showed two solid masses in the abdomen suggestive of malignant disease. Additional diagnostic procedures did not prove malignancy and biopsies showed chronic inflammation. In the absence of proof of malignancy and with regard to the long-term IUD use, actinomycosis was considered. A Pap smear showed Actinomyces 5 years earlier. Antibiotic treatment was instituted and remission of the intra-abdominal masses was seen after six months of treatment. CONCLUSION: Consider actinomycosis in a patient presenting with abdominal pain and (long-term) IUD use. Diagnosis is challenging and frequently impossible to confirm before treatment. This diagnosis should be considered after thorough workup for other diseases, especially malignancy. After such analysis, starting antibiotic therapy could prevent secondary complications and invasive procedures.

Post-menopausal vaginal bleeding caused by carcinoma of the appendix: a case report.

INTRODUCTION: Post-menopausal blood loss is a common complaint of patients seen in gynecological practice. The most frequent malignancy found in cases of post-menopausal bleeding is endometrial cancer. Other causes can be malignancies of the rest of a woman's genital tract or metastases from other tumors. To the best of our knowledge, it appears that this is the first published case of a post-menopausal primary appendiceal carcinoma presenting with vaginal blood loss. CASE PRESENTATION: A 75-year-old Caucasian woman with a history of vaginal hysterectomy presented with a 10-month history of post-menopausal blood loss. After extensive examination and discussion, ovarian carcinoma was suggested. Microscopic examination of the tissue removed at laparotomy revealed an adenocarcinoma of the appendix. She was treated with adjuvant radiotherapy and with palliative chemotherapy after 14 months because of intra-abdominal metastatic disease. CONCLUSION: Post-menopausal blood loss in a patient with a history of hysterectomy is uncommon and always needs further investigation.

Seroprevalence of Bordetella pertussis infection during pregnancy measured by IgG antibodies against pertussis toxin.

Bordetella pertussis infection may cause severe illness in newborns. Mothers with B. pertussis infection during delivery can infect newborns. The seroprevalence of B. pertussis infection in pregnancy was measured in pregnant women by detection of immunoglobulin G against pertussis toxin; 6.3% had serological evidence of infection. Maternal vaccination should be considered to prevent pertussis in newborns.

Nearly fatal uterine rupture during manual removal of the placenta: a case report.

BACKGROUND: A uterine scar is a well-known riskfactorfor both abnormal placentation and uterine rupture, both of which may lead to a serious obstetric hemorrhage. CASE: A 23-year-old woman, gravida 2, para 0 with a history of first-trimester dilatation and curettage (D&C) experienced a life-threatening obstetric hemorrhage due to uterine rupture during manual removal of a placenta increta. Cessation of the bleeding occurred only following secondary embolization after hysterectomy. CONCLUSION: Obstetricians should be aware of the risk of uterine scarring and abnormal placentation in women who have undergone D&C, as it could lead to a life-threatening obstetric hemorrhage.