A 30-year-old woman with an intrauterine contraceptive device in situ for five years presents with chronic pelvic pain and a purulent discharge. Endometrial curettings show suppurative inflammation containing basophilic masses with radiating club-like projections. The causative organism is:
- A Actinomyces israelii ✓
- B Mycobacterium tuberculosis
- C Chlamydia trachomatis
- D Gardnerella vaginalis
Correct answer: A. Actinomyces israelii
Explanation
Sulfur granules, basophilic masses with radiating filamentous clubs, are characteristic of Actinomyces israelii, an anaerobic Gram-positive filamentous bacterium associated with long-term intrauterine device use. Tuberculosis produces caseating granulomas without sulfur granules, chlamydia gives intracytoplasmic inclusions, and Gardnerella causes clue cells on wet mount. Removal of the device plus penicillin or tetracycline therapy constitutes treatment.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.