Abstract
A 57-year-old man with a background of chronic pancreatitis presented with acutely worsening abdominal pain and vomiting. He previously had a pancreatic duct stent in situ which had been removed 1 year prior to presentation. Initially suspected to be acute-on-chronic pancreatitis, a computed tomography (CT) scan of the abdomen and pelvis revealed an atrophic pancreas and a new mass in the pancreatic head, raising the suspicion of pancreatic malignancy. An urgent endoscopic ultrasound (EUS)-guided fine needle biopsy of the pancreatic head mass surprisingly revealed the presence of actinomyces colonies on histological evaluation. Prompt initiation of a prolonged antibiotic course led to significant clinical and radiological improvement. This case highlights the rare presentation of pancreatic actinomycosis which can often masquerade as malignancy. Although a gut commensal, actinomyces can elicit pathogenic effects if allowed to enter tissues through a breach in the mucosal lining such as following abdominal surgery or pancreatic duct intervention as observed in this case. Early recognition and appropriate treatment with antibiotics can lead to clinical recovery and complete resolution of the infection.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: The journal of the Royal College of Physicians of Edinburgh
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
