OVARY - Actinomycosis

The cut surface of the ovary shows a number of cysts, some containing thick greenish purulent material.
This woman presented with fatigue, pneumaturia and weight loss over a period of several months. Examination showed a mass in the lower abdomen. At operation a right tubo-ovarian mass was found, involving the anterior surface of the bladder and two loops of ileum. There was a fistula to the bladder and to the sigmoid colon. There was a dermoid cyst in the left ovary. Actinomyces Israelie was recovered from lesion.