2 the surgical resection there was an incidental dissection of the intestinal serosa near the tubo-ovarian complex. Bilat- eral salpingo-oophorectomy was done with complete resec- tion of the plastron and suture of the serosa was also done. Three days later the patient was readmitted by acute ab- domen, she was taken back to the operation room for a new laparotomy. The ﬁndings during the laparotomy were as follows: generalized peritonitis secondary to a perforation at the level of the ileum and rectum, which required man- agement with a colostomy. The histopathological study was compatible with bilateral tubo-ovarian abscess with infec- tion by actynomyces. The patient received antibiotic ther- apy with crystalline penicillin 24 000 000 IU per day intra- venously. Once the histopathology diagnosis was conﬁrmed the patient continued therapy with ampicillin for another 6 months. DISCUSSION The actynomyces infection is a chronic infection. It is caused by the actynomyces organism which is a gram positive anaer- obe. The infection is usually localized around the cervicofa- cial area, but it could also be present with manifestations at the lungs, abdominal, or urogenital levels [1]. The infection that presents at the pelvic level corresponds to a 10 to 15% of all reported cases. There is a higher incidence of the in- fection in males than females, except in the abdominal and pelvic localization where the higher incidence is in females. It has been reported as an incidence of 1 to 16% of all of the pelvic infections [2]. Actynomyces is a rare cause of chronic infection; it causes local inﬁltration and induration of the tissues. Its role as a pathologic entity in the genital female tract is discussed because its manifestations have a wide spec- trum that includes: asymptomatic infection, chronic pelvic pain, adnexal mass, tubo-ovarian complex, tumor-like carci- noma, and pelvic adhesion syndrome. The preoperative di- agnosis is hard to achieve due to the ﬁnding of the microor- ganism by culture or immunoﬂuorescence studies of vagi- nal secretion without being pathologic or any association to abdominal pain or sepsis. Although the chance of making a precise diagnosis is very attractive because it could change the therapeutic options, these facts we must consider: it is a nonmalignant process; it is a microorganism very sensible to B-lactams antibiotics; the radical surgery in some cases can be complicated with dissection of the intestinal and urinary tracts [3]. Once the diagnosis has been conﬁrmed, the pa- tients should be on long term therapy with B-lactams antibi- otics. REFERENCES [1] Soria-Aledo V, Flores-Pastor B, Carrasco-Prats M, et al. Ab- dominopelvic actinomycosis: a serious complication in in- trauterine device users. Acta Obstetricia et Gynecologica Scan- dinavica. 2004;83(9):863–865. [2] Mej´ıa Salazar YR, Herna´ndez Gonza´lez M, Mart´ınez Reyes Z, Carrera Rivapalacio A. Tuboovaric actinomycosis. A report of a case. Ginecologia y Obstetricia de Mexico. 2004;72:162–165. Infectious Diseases in Obstetrics and Gynecology [3] Marella VK, Hakimian O, Wise GJ, Silver DA. Pelvic actino- mycosis. Urologic perspective. International Braz J Urol. 2004; 30(5):367–376.