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June 10, 1983

Systemic Actinomyces Infection

Author Affiliations

The Stamford Hospital Stamford, Conn

JAMA. 1983;249(22):3016-3017. doi:10.1001/jama.1983.03330460016014

To the Editor.—  I would like to comment on the article by de la Monte and co-workers entitled "Systemic Actinomyces Infection" (1982;248: 1876). In their article, the authors presented an interesting case report of persistent systemic actinomycosis infection and a brain abscess that developed several years after removal of the uterus, both fallopian tubes, and one ovary with a tubo-ovarian abscess. Review of the pathologic condition revealed Actinomyces israelii in both tubes, the uterus, and the ovarian abscess.In addition to not being treated with therapeutic doses of antibiotics that the authors noted and commented on, it would seem that the remaining ovary may have been the offender and responsible for the persistent systemic actinomycosis infection. It is not easy to assess the presence or absence of infection in a "normal ovary" when there is an abscess in the other. Nonvisible lymphatic or vascular involvement may well be present in