In 1934, Cornell1 reviewed the literature on actinomycosis of the internal female genitalia and found 71 published cases, including those in which the process was listed as parametrial. In 1937, Lisa and Levine2 found 5 additional cases in the literature and described 1 of their own.
The history usually given is one of a chronic pelvic inflammatory condition, and in most cases it cannot be differentiated from other chronic pelvic inflammatory processes. The diagnosis may be made by examination of the pus obtained at colpotomy. However, in routine examinations the actinomycetes may easily be overlooked. The direct smears may show no evidence of actinomycosis, or the fragments of any hyphae present may easily be mistaken for long bacilli. Aerobic and particularly anaerobic cultures on appropriate mediums should be made. From surgical and autopsy material the diagnosis can be established by the characteristic structure of the ray fungi in
TUTA JA. PELVIC ACTINOMYCOSIS. Arch Surg. 1941;42(6):1060-1064. doi:10.1001/archsurg.1941.01210120095011