Abdominal Actinomycosis Research Articles

Abdominal actinomycosis complicated with hydronephrosis.

Actinomycosis is a chronic supportive granulomatosis disease caused by the anaerobic Gram-positive organism Actinomyces. We report a 16-year-old boy with abdominal actinomycosis who presented with a 2-week history of intermittent abdominal pain. He complained of oliguria during the 3 days prior to admission. Abdominal computed tomography revealed a large inflammatory mass obstructing the ureter, which led to hydronephrosis of the right kidney. Exploratory laparotomy was performed and actinomycosis was confirmed by the presence of sulfur granules and filamentous bacteria. Postoperatively, the patient was successfully treated with long-term penicillin and recovered completely.

A rare case of abdominal actinomycosis presenting as an inflammatory pseudotumour

A rare case of abdominal actinomycosis presenting as an inflammatory pseudotumour

Une pseudocarcinose péritonéale

Abdominal actinomycosis is an unusual peritoneal disease due to actinomyces, which are Gram-positive bacillus bacteria. Those saprophytes pathogens of digestive tract and genital mucous, can appear accidentally in the peritoneum cavity, in tumor form, simulating a neoplasic disease. We report the case of a 43-year old woman, with abdominal actinomycosis, revealed by feverish bowel obstruction. During laparotomy, several nodes were removed. Their histologic study permitted the diagnosis. Long-term antibiotics treatment allowed patient recovery.

Submucosal nodules containing purulent fluid: a colonoscopic sign of actinomycosis?

Actinomycosis is a rare chronic disease characterized by a suppurative and granulomatous response to Actinomyces infection, often complicated by fibrotic scarring and mass formation. 1. Bullock W.E. Actinomycosis. in: Goldman L. Bennett J.C. Cecil textbook of medicine. 21st ed. W.B. Saunders, Philadelphia2000: 1714-1715 Google Scholar Differential diagnosis can be complex because multiple systems can be involved and the clinical picture may resemble several diseases, including malignancies. 2. Waaddegaard P. Dziegiel M. Actinomycosis mimicking abdominal neoplasm. Acta Chir Scand. 1988; 154: 315-316 PubMed Google Scholar Diagnostic evaluation is laborious, frequently requiring multiple radiologic, endoscopic, and surgical procedures. 3. Putman H.C. Dockerty M.B. Waugh J.M. Abdominal actinomycosis: an analysis of 122 cases. Surgery. 1950; 28: 781-801 PubMed Google Scholar Abdominal-pelvic localization is a severe manifestation of actinomycosis, because it can extend by contiguity to organs such as the liver or the spine. 4. Davies M. Keddie N.C. Abdominal actinomycosis. Br J Surg. 1973; 60: 18-22 Crossref PubMed Scopus (72) Google Scholar Colonic involvement typically is caused by infiltration of Actinomyces through minute mucosal lesions and can occur after surgical procedures 5. Piper M.H. Schaberg D.R. Ross J.M. Shartsis J.M. Orzechowski R.W. Endoscopic detection and therapy of colonic actinomycosis. Am J Gastroenterol. 1992; 87: 1040-1042 PubMed Google Scholar or as complication of appendicitis or, more rarely, diverticulitis. 6. Deshmukh N. Heaney S. Actinomycosis at multiple colonic sites. Am J Gastroenterol. 1986; 81: 1212-1214 PubMed Google Scholar Less frequently, the bowel wall may be seeded by contiguity when peritoneal infection is present. 7. Yeguez J.F. Martinez S.A. Sands L.R. Hellinger M.D. Pelvic actinomycosis presenting as malignant large bowel obstruction: a case report and a review of the literature. Am Surg. 2000; 66: 85-90 PubMed Google Scholar The endoscopic appearance is non-specific, usually submucosal nodules or masses involving the ileocecal region, the appendix, or, less frequently, the rectosigmoid region. 5. Piper M.H. Schaberg D.R. Ross J.M. Shartsis J.M. Orzechowski R.W. Endoscopic detection and therapy of colonic actinomycosis. Am J Gastroenterol. 1992; 87: 1040-1042 PubMed Google Scholar , 6. Deshmukh N. Heaney S. Actinomycosis at multiple colonic sites. Am J Gastroenterol. 1986; 81: 1212-1214 PubMed Google Scholar , 8. Yang S.H. Li A.F.Y. Lin J.K. Colonoscopy in abdominal actinomycosis. Gastrointest Endosc. 2000; 51: 236-238 Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar , 9. Kim J.C. Ahn B.Y. Kim H.C. Yu C.S. Kang G.H. Ha H.K. et al. Efficiency of combined colonoscopy and computed tomography for diagnosis of colonic actinomycosis: a retrospective evaluation of eight consecutive patients. Int J Colorectal Dis. 2000; 15: 236-242 Crossref PubMed Scopus (17) Google Scholar A case is presented of abdominal-pelvic actinomycosis characterized by an unusual endoscopic finding of multiple bulging submucosal nodules confined to the sigmoid colon without evidence of diverticular disease or other potential mucosal defect.

Abdominal actinomycosis

Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the last ten years. We report three cases of abdominal actinomycosis and a literature review of the last eight years. All three patients were diagnosed by means of histopathologic examination only. In one case, an intrauterine device (IUD) was associated with the infection. Therapy consisted of surgical resection of the inflammatory, infected tissue, and long-term antibiotic therapy. All patients are free of recurrence. Abdominal actinomycosis should be included in the differential diagnosis of an abdominal pathology of insidious onset, especially when an IUD is in place. Even when infection had spread extensively, combined operative and antibiotic therapy cured most of the cases.

Un cas d’actinomycose abdominale chez un enfant malgache

Abdominal actinomycosis is a rare and unrecognised disease. It is a chronic granulomatous suppurating infection caused by bacterial infection. The symptomatology is not specific including a tumour like abdominal lesion fistulized to the skin with issue of characteristic yellow granules. We report a case of a 12-year old boy with an abdominal mass fistulized to the navel in whom surgical treatment needs large resection of the tumour, resection anastomosis of the ileum and temporary colostomy. The diagnosis of actinomycosis was made by histolopathological study of the surgical specimen. This case demonstrates the difficulty to make a pre-operative diagnosis. To improve the prognosis, actinomycosis needs early diagnosis and should be included in the differential diagnosis of infiltrative neoplasic abdominal masses apparently.

A case of abdominal wall actinomycosis

A case of abdominal wall actinomycosis

MR Findings of Hepatic Actinomycosis: Case Report

Actinomycosis is an uncommon chronic infectious disease caused by Actinomyces. There are three distinct forms of the condition, namely cervicofascial, thoracic, and abdominal; the hepatic variety is an unusual form of abdominal actinomycosis, accounting for about 15% of cases of this type. Many reports of actinomycosis have been published, but few have detailed the MR findings of hepatic actinomycosis. We describe the contrast-enhanced CT and MR findings in one case of hepatic actinomycosis.

Actinomycosis imitating an adrenal tumor

Abdominal actinomycosis is a rare condition that may mimic malignant disease. The authors report a case of adrenal actinomycosis discovered incidentally by computed tomography scan of the abdomen. Frozen sections and culture of the mass were consistent with actinomycosis. The diagnosis and management of actinomycosis is discussed in detail. J Pediatr Surg 37:930-931. Copyright 2002, Elsevier Science (USA). All rights reserved.

Actinomicosis primaria de la pared abdominal: Descripción de dos casos y revisión de la literatura

We report two cases of isolated abdominal wall actinomycosis and review 18 previously reported cases to further characterize the clinical findings and the therapeutic management of this syndrome. This diagnosis would be advocated in patients with a palpable abdominal mass of subacute appearance with a previous history of digestive medical illness, diabetes, abdominal surgery, or prolonged IUD use. In contrast with other actinomycosis locations, remarkable data were a more elevated mean age of patients; a female predominance; a prevalent location of mass in abdominal lower left quadrant; and a shorter duration of symptomatology before to diagnosis. The CT is the first choice for imaging study and percutaneous needle aspiration would be recommended for definite diagnosis. The long-term antibiotic therapy, with or without percutaneous drainage, is the first treatment choice because is very effective and made unnecessary a more invasive surgical management. The prognosis is excellent with adequated treatment.

Aktinomykose des Sigma als Ursache von Unterbauchschmerzen

We report a case of abdominal actinomycosis in a young woman wearing an intrauterine contraceptive device. The patient presented with right lower abdominal pain. A diagnostic laparoscopy was performed. Intraoperatively two perforations of the sigma were detected, a sigmoidectomy was performed. Postoperatively no problems occurred. Histology revealed an abdominal actinomycosis. In the literature only some case reports are published dealing with abdominal actinomycosis. Women wearing intrauterine contraceptive devices seem to have a higher risk of actinomycosis. In unproblematic cases antibiotic therapy is the treatment of choice. In cases of doubt as in our case surgery is recommended to confirm the diagnosis.

A case report of abdominal wall actinomycosis associated with prolonged use of an intrauterine device

A case report of abdominal wall actinomycosis associated with prolonged use of an intrauterine device

Colonoscopy in abdominal actinomycosis

Abdominal actinomycosis has been called “one of the greatest imitators in clinical practice.”1 In addition, its variety makes it difficult to accumulate experience with the disease. Actinomycosis is a chronic suppurative infection due to a grampositive, non-spore-forming, anaerobic bacteria. The organisms are indigenous in the oral cavity, GI tract, and genital tracts, with opportunistic infection occurring when the mucosal barrier is broken,2 leading to multiple abscess formation, fistula, or a mass lesion. Actinomycosis has three major forms of clinical manifestation: cervicofascial, thoracic,3 and abdominal.4 We present a case of abdominal actinomycosis with an interesting endoscopic and radiologic picture.

Pelvic Actinomycosis Presenting as Malignant Large Bowel Obstruction: A Case Report and a Review of the Literature

Actinomycosis is an infrequent chronic infectious disease. In most cases the diagnosis is made postoperatively because of its unusual clinical presentation. Moreover, abdominal actinomycosis may mimic cancer, inflammatory bowel disease, or diverticulitis. Delay in diagnosis leading to inadequate management and unnecessary procedures has been reported. We report the case of a 49-year-old woman with large bowel obstruction secondary to extensive pelvic actinomycosis involving the rectosigmoid and cecum. She required emergency surgery, which involved both resection and colostomy. A review of the literature on abdominal actinomycosis during the last 50 years is also reported. Rarely has emergency surgery been described in this condition. Although the incidence of actinomycosis has decreased, the abdominal-pelvic form has been increasing over the past 10 years secondary to increased prolonged use of the intrauterine device. As the clinical spectrum of actinomycosis has dramatically changed, so have the therapeutic considerations. Aggressive surgical management in advanced cases with multiorganic involvement seems to have reemerged in recent years. Consideration of actinomycosis in a woman with prolonged use of an intrauterine device and symptoms of bowel obstruction could help to improve the preoperative diagnosis and management of this rare disease.

Actinomyces meyeri, Gangrenous Cholecystitis, and Invasive Carcinoma of the Gallbladder

Actinomycosis is a chronic suppurative infection caused by grampositive filamentous organisms of the genus Actinomyces. Infection is often characterized by a tendency to form multiple abscesses with draining sinus tracts and may involve the cervicofacial region, thorax, or abdomen [1]. Actinomyces is also considered an opportunistic pathogen, and intraabdominal infection is associated with trauma or surgical procedures [2]. Abdominal actinomycosis is rare, and hepatobiliary involvement is exceedingly rare. Loss of the mucosal barrier function and subsequent invasion by the organism seems to be the common pathogenetic mechanism [3]- Theoretically, invasive carcinoma of the gastrointestinal or hepatobiliary tracts would predispose patients to develop intraabdominal actinomycosis; however, only one previous case of gallbladder carcinoma associated with biliary actinomycosis has been reported [4]. We report a case of acute gangrenous cholecystitis caused by A. meyeri in a patient with villous adenoma and invasive intramucosal carcinoma of the gallbladder.

CT Findings in Abdominal Actinomycosis

Abdominal actinomycosis is a chronic, progressive, suppurative disease with a fa-vorable response tointravenous treatment with penicillin. In many instances, howev-er, its clinical and radiological findings mayoverlap with those of other inflammatory and neoplastic conditions, and the familiarity with the variousradiological features can thus avoid diagnostic delay s. The purpose of this paper is to describe and discuss the CT findings of abdominal actinomycosis.

Disseminierte abdominale Aktinomykose in der Differentialdiagnose genitaler Tumoren

Genital actinomycosis is rare and leads to a variety of symptoms, so that diagnosis is made in most cases after operation only. We report on a 53-year old woman presenting with rapidly growing uterus myomatosus, weight loss and leucocytosis. While preoperative diagnostic examinations were suspicious for a malignant process, intraoperative histological evaluation showed evidence of an abscess-forming infection. The final postoperative histological evaluation revealed abdominal actinomycosis. In a review of the literature, the most important aspects of genital actinomycosis are discussed, paying special attention to its role in differential diagnosis.

Colitis and lower abdomimal mass by Actinomyces israelii in a patient with an IUD

Abdominal actinomycosis is a rare disorder. The diagnosis is frequently missed preoperatively. We describe a patient who had had an intrauterine contraceptive device in situ for 5 years. She presented with a painful pelvicoabdominal mass, located between the uterus and rectum, and a colitis-like disease of the distal colon. Culture of the removed IUD demonstrated Actinomyces. She was intensively treated with intravenously penicillin for six weeks. Following this conservative treatment the abdominal tumor and the colitis-like symptoms totally disappeared. During two years follow-up she is free of symptoms and no signs of recurrence of the disease have been noticed. The case described here strongly underlines that Actinomyces infection should be born in mind in the differential diagnosis of a young female with an IUD, presenting with colitis, fever and an abdominal mass. Prolonged intravenously administered penicillin is warranted before surgery should be considered.

A CASE OF ACTINOMYCOSIS OF THE SIGMOID COLON DIAGNOSED AS MALIGNANT DISEASE PREOPERATIVELY

A case of abdominal actinomycosis which was diagnosed as malignant disease preoperatively is reported. A 61-year-old man had a palpable tumor in the left lower quadrant of the abdomen. Barium enema showed an irregular stenotic lesion of the sigmoid colon, and thereafter, he suffered from obstructive symptoms. Under a preoperative diagnosis of diffuse infiltrative carcinoma or metastatic carcinoma of the sigmoid colon, an operation was performed in the same way as malignant disease. Light microscopic examination of the resected tissues revealed abdominal actinomycosis, showing sulfur granules in the abscess. Abdominal actinomycosis is chronic suppurative granulomatous infection caused by Actinomyces which forms a part of the normal flor of the human mouth and gastrointestinal tract. To make the preoperative diagnosis for the disease is extremely difficult. It is important to bear in mind this disease as a probable diagnosis when the abdominal tumor is encountered. In histopathological examination, we should cut the surgical specimen into a lot of pieces in order to demonstrate sulfur granules.

A CASE OF ABDOMINAL ACTINOMYCOSIS ORGINATED IN THE GREATER OMENTUM

An extremely rare case of abdominal Actinomycosis originated in the greater omentum was experienced. The case involved a 68-year-old woman with diabetes mellitus. She was seen at the hospital because of a palpable abdominal mass preceded by abdominal pain. Characteristic features of the mass included hardness, tenderness, and poor movability. The white blood cell count was within normal range. After admission abdominal CT revealed a mass 6cm in diameter just under the abdominal wall of the right lower abdomen which was poorly-defined at the wall-side; and visualized a thickened abdominal wall, from which direct invasion was suspected. On the other hand the deepest portion was smooth, and there was a cavity in the mass with a protrusion mimicking an intramural tumor. Abdominal ultrasonography showed a hypoechoic and intrenally heterogenous tumor with cystic structure partially. It was difficult to rule out a possibility of malignant tumor, because abdominal findings were slight, leukocytosis was lacked, no response was attained by administration of antibiotics, the tumor tended to increase, and CT findings indicated an invasive growth into the abdominal wall. Operation was carried out. The removed specimen was a 7×7 ×5cm solid tumor comprizing of the greater omentum and rectus abdominis muscle including a tumorous tissue. It was granuloma with yellow-green pus. Actinomycosis was determined pathologically by the findings of sulfur granule. The patient was diagnosed as abdominal Actinomycosis originated in the greater ometum.