Colonic Actinomycosis Presenting as Diffuse Colitis and Protein-Losing EnteropathyA Case Report

Abstract

Actinomycosis is a rare, chronic, spreading, supurative, granulomatous, and fibrosing infection that is accompanied by the formation of deep abscesses and extensive sinuses that drain through the skin, and characteristic “sulfur granules” within the draining material.1 Actinomycosis generally involves the face and neck,2 particularly after dental procedures. GI tract involvement is an initial manifestation in approximately 20% of patients and may mimic appendicitis, diverticulitis, neoplasm, or Crohn's disease.3 Because the bacterium is anaerobic and difficult to grow on culture media, diagnosis frequently depends on histopathologic confirmation.4,5 Intra-abdominal actinomycosis usually is related to abdominal surgery or organ perforation and presents as an intra-abdominal mass. Although the bacteria may aggressively invade contiguous organs, the GI mucosa generally is uninvolved.4,6,7 A case of colonic actinomycosis presenting as diffuse colitis and a colonic mass associated with protein-losing enteropathy is described.