Abstract
Actinomyces species has been described as an opportunistic pathogen, particularly in the oral cavity; however, in rare cases these bacteria can cause actinomycosis which is characterized by formation of abscesses in the mouth, lungs, or gastrointestinal tract.Actinomycosis was commonly present in the pre-antibiotic era; however, it has a low prevalence now days. It has been recognized since 150 years ago, but because of its variable clinical presentation and indolent course, its recognition is difficult and patients are often misdiagnosed. Here we present a case of primary hepatic actinomycosis presenting as a metastatic liver tumor.
Highlights
Actinomyces species has been described as an opportunistic pathogen, in the oral cavity; in rare cases these bacteria can cause actinomycosis which is characterized by formation of abscesses in the mouth, lungs, or gastrointestinal tract
Case report This is the case of a 65-year-old male, who originally presented on August 18, 2008 with obstructive jaundice
Over the course of one year he was admitted to the hospital on several occasions for low-grade fever, for which the diagnosis was not established, and at times treated as an outpatient for multiple urinary tract infections
Summary
The genus Actinomyces species are a slowing growing, gram-positive, non-spore-forming bacteria, that thrive in microareophilic and anaerobic conditions [1]. The infection tends to lead a chronic and suppurative infection leading to fibrosis with draining sinuses that are pale yellow and often referred to as “sulfur granules” [6] The wall of these mass are often “wooden” in consistency [2]. Our patient presented with one year history of indolent course with nonspecific and undiagnosed causes of fevers and hospital admissions, treated with antibiotics. He never had an immunosuppressive work-up but his white blood cell count and total lymphocyte count were always normal.
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