Abstract
Background: Abdominal actinomycosis is a rare chronic infectious disease. There are only a few reports of the disease of chronic appendicitis pattern. We present a case of abdominal actinomycosis mimicking chronic appendicitis. Case: A 29-year old male was admitted with symptoms of right low quadrant pain for a few weeks. An abdominal computed tomography scan revealed a solid mass without a clear border, near the cecum. On colonoscopy, normal colon and terminal ileum were seen, except for mild edema and a few tiny erosions around the appendiceal orifice. The patient received an antibiotic treatment. Three month later, abdominal ultrasound was performed and revealed the appendix enlarged to 9 mm, with thickened and hyperemic wall. Appendectomy was performed. On microscopic examination chronic active appendicitis containing Actinomycotic sulfur granules within inflammatory infiltrate was described. Treatment by Amoxicilline was recommended for 6 months.
Highlights
Actinomycosis is an uncommon chronic infectious disease
A 29-year old male was admitted with symptoms of Right Low Quadrant (RLQ) pain for a few weeks before admission
An abdominal ultrasound was performed and revealed a normal cecum and terminal ileum, the appendix was enlarged to 9 mm, with thickened and hyperemic wall, no free abdominal liquid and no enlarged lymph nodes were identified
Summary
Actinomycosis is an uncommon chronic infectious disease. Abdominal actinomycosis represents 20% of the cases. The most common presentation of appendiceal actinomycosis is acute, mimicking acute appendicitis. There are case reports of the disease mimicking appendiceal tumor.
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