Definitive diagnosis Presumptive diagnosis Definitive method of diagnosis Previous use of IUD Treatment and resolution Number of cases Age (years) Reference Actinomyces israelii Tubo-ovarian abscess Histopathological report and culture Yes (4 years) Type: Dalkon Shield IUD Laparotomy, hysterectomy, bilateral salpingo-oophorectomy, and penicillin Complete resolution 1 29 1980, McLeod et al. United States [47 ] Actinomycotic tubo-ovarian abscess Tubo-ovarian abscess or malignant tumour Histopathological report Yes Type: Antibiotic therapy, tumourectomy, and right salpingo-oophorectomy No date of resolution 1 29 1982, Kelly and Aaron United States [48 ] A. naeslundii Pelvic abscess Microscopic observation of the IUD and culture Yes (10 years) Type: Dalkon Shield IUD Antibiotic therapy hysterectomy, bilateral salpingo-oophorectomy Complete recovery 1 39 1985, Bonnez et al. United States [49 ] Sulphur granules; Actinomyces israelii ; actinomycotic pelvic abscess secondary to IUD involving the bladder, sigmoid colon, left ureter, liver, and superior abdominal wall ND Histopathological report and culture Yes (15 years) Type: Lippes loop IUD Percutaneous drainage and prolonged antibiotic therapy No date of resolution 1 41 1996, Hochsztein et al. United States [50 ] Actinomycotic granules, tubo-ovarian abscess Abdominal tumour secondary to colon cancer Laparotomy Yes Type: copper IUD Laparotomy, en bloc resection that included compromised abdominal wall, right hemicolectomy, hysterectomy, bilateral salpingo-oophorectomy, partial sigmoidectomy, and penicillin Complete recovery 1 47 1999, Mesa-Castillo et al. Colombia [51 ] ND Histopathological report Yes (9 and 3 years) Type: ND Laparotomy, hysterectomy, oophorectomy, penicillin, and amoxicillin Significant improvement 2 38 and 23 2006, Urbina et al. Colombia [52 ] Actinomyces sp.Bilateral cystic teratoma Histopathological report No Laparotomy, bilateral salphingo-oophorectomy, and penicillin Significant improvement 1 47 2001, Burlando et al. Argentina [53 ] Tubo-ovarian actinomycosis, MSA Tumour formation Histopathological report of the ovary Yes (8 years) Type: ND Oophorectomy, right salpingectomy, and amoxicillin No date of resolution 1 41 2005, Vispo et al. Argentina [54 ] Actinomycosis, MSA Vesical tumour Histopathological report Yes (33 years) Type: ND Penicillin Progressive improvement 1 58 2003, Alegría et al. Chile [55 ] Pelvic actinomycosis, sulphur granules Pelvic or neoplastic actinomycosis of the colon or ovary IUD swab Yes (27 years) Type: Lippes loop IUD Penicillin and amoxicillin Significant improvement 1 54 2013, Daniels et al. Chile [56 ] MSA ND Histopathological report of the right ovary Yes (22 years) Type: ND Laparotomy to drain purulent material, hysterectomy with bilateral salpingo-oophorectomy, and penicillin Significant improvement 1 48 2004, López-Cervantes et al. México [57 ] MSA Actinomycotic granuloma Uterine myomatosis Histopathological report Yes (10, 10, and 4 years) Type: ND Laparotomy, hysterectomy, salpingo-oophorectomy, and penicillin Significant improvement 3 36, 37, and 39 2005, Olivera-Reynada et al. Mexico [58 ] Coinfection by Neisseria gonorrhoeae and Actinomyces naeslundii ND Culture of UID and vaginal exudate Yes (22 months) Type: copper IUD Surgical excision of the appendix, bilateral salpingectomy No date of resolution 1 36 2013, Eiros-Bouza et al. Mexico [59 ] Urachal actinomycosis, “sulphur granules” Carcinoma Histopathological report ND Partial cystectomy Complete recovery 1 46 2013, Alfonso et al. Mexico [60 ] Actinomyces spp.Cyst in the left ovary and abscess in the iliac fossa Purulent material, histopathological report Yes (2 years) Type: ND Laparotomy, cefotaxime, metronidazole, and penicillin Gradual recovery 1 18 2004, Mejia et al. Mexico [61 ] Actinomyces urogenitalis ND Microscopic observation of the IUD, sequencing of the 16S rRNA gene Yes Type: ND Oral amoxicillin Complete recovery 1 38 2006, Elsayed et al. Canada [62 ] Ovarian actinomycosis Left tubo-ovarian abscess Haematoxylin-eosin (HE) staining microscopy No Exploratory laparotomy, unilateral oophorectomy, and penicillin Complete recovery 1 49 2013, Bes et al. Brazil [63 ] Total cases 20