Intra-abdominal actinomycosis with hepatic pseudotumor and xanthogranulomatous pyelonephritis in a 6-y-old boy

Area of Science:

• Pediatric Infectious Diseases
• Medical Microbiology
• Abdominal Imaging

Background:

• Actinomycosis is a rare bacterial infection often presenting with nonspecific symptoms.
• Xanthogranulomatous pyelonephritis (XGP) is a rare chronic inflammatory condition of the kidney that can mimic malignancy.
• Pediatric presentations of actinomycosis, especially mimicking abdominal tumors, are exceptionally uncommon.

Observation:

• A 6-year-old boy presented with intermittent fever, abdominal pain, and weight loss.
• Imaging studies (sonography and CT) revealed masses suggestive of hepatic pseudotumor and renal tumor.
• Pathological examination confirmed actinomycosis and XGP.

Findings:

• The patient was diagnosed with disseminated actinomycosis presenting as XGP, hepatic pseudotumor, and abdominal abscess.
• Diagnosis was confirmed through histopathological analysis.
• The child showed a complete clinical recovery following antibiotic therapy alone.

Implications:

• This case highlights the importance of considering actinomycosis in the differential diagnosis of pediatric abdominal masses, even in the absence of typical risk factors.
• Early and accurate diagnosis through pathology is crucial for effective management.
• Antibiotic therapy alone can be sufficient for treating complex pediatric actinomycosis presentations.