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Geislagerlabólga í sjötugri konu með gleymda lykkju : sjúkratilfelli og yfirlit um sjúkdóminn

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Authors
Ragnar Freyr Ingvarsson
Lárus Jónasson
Hafsteinn Sæmundsson
Magnús Gottfreðsson
Issue Date
2007-06-01

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Other Titles
Actinomycosis in a 70 year old woman with a forgotten intrauterine contraceptive device
Citation
Læknablaðið 2007, 93(6):479-85
Abstract
Actinomycosis is an infectious disease that has been known since the late nineteenth century. In the pre-antibiotic era it was thought to be rather common but with increased use of antimicrobial agents its incidence has decreased significantly. The causative agent, most commonly Actinomyces israelii, is part of the commensal bacterial flora. It can infect any tissue, respects no tissue boundaries and can spread throughout the body. The clinical presentation of this illness can be similar to malignant disease and definite diagnosis is sometimes not apparent until after surgery and histologic examination. We report the case of a 71 year old woman who suffered from actinomycosis of the uterus and ovaries due to a forgotten intrauterine contraceptive device that had been in place for over four decades. The disease presentation was consistent with malignant disease and tumor markers, CA 125, CA 19-9 and CEA, measured in blood were elevated. She was treated successfully with total hysterectomy and bilateral salphingo-oophorectomy, as well as penicillin for six months.
Geislagerlabólga (actinomycosis) er sjúkdómur sem þekktur hefur verið síðan um lok nítjándu aldar. Fyrir tíma sýklalyfja var hann fremur algengur, en með tilkomu sýklalyfja hefur verulega dregið úr algengi sjúkdómsins. Sýkillinn er oftast Actinomyces israelii og finnst víða í líkamanum sem hluti af eðlilegri bakteríuflóru. Hann getur lagst á alla vefi, virðir ekki hefðbundin vefjamörk og getur dreifst víða. Birtingarmynd sýkingarinnar getur verið áþekk krabbameini og oft liggur endanleg greining ekki fyrir fyrr en eftir skurðaðgerð og vefjarannsókn. Hér er lýst sjúkratilfelli þar sem 71 árs gömul kona fékk geislagerlabólgu í leg og eggjastokka út frá lykkju sem hafði verið til staðar í rúmlega fjóra áratugi og gleymst. Birtingarmynd sjúkdómsins var áþekk því að um krabbamein væri að ræða og voru æxlisvísarnir CA 125, CA19-9 og CEA hækkaðir. Konan var læknuð með brottnámi á legi og eggjastokkum ásamt penicillíngjöf í sex mánuði.
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Additional Links
http://www.laeknabladid.is/2007/06/nr/2830
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Icelandic Journal Articles (Peer Reviewed)

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