Abdominal actinomycosis: a rare complication after cholecystectomy

Abstract

We present a single case of abdominal actinomycosis occurring in a 74-year-old female with a history of cholecystectomy 42 months before presentation. In a review of the literature, we present risk factors, clinical characteristics, diagnosis, and treatment of this infection. Abdominal actinomycosis is a rare, chronic, granulomatous infection characterized by the release of ‘sulphur granules’. Actinomyces species should always be part of the differential diagnosis of patients presenting with a history of surgical or invasive procedures, presenting with an abdominal mass. Computed tomography (CT)-guided aspiration with or without core biopsy of this mass is a useful investigation. Diagnosis is often difficult: In less than 10% of cases, the diagnosis is made pre-operatively. Definitive diagnosis is often based on histochemical, macroscopic, and microscopic examination of tissue specimens. The disease should be treated with high doses of intravenous penicillin for 2–6 weeks followed by oral therapy for at least 6–12 months.