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[Acute retrocecal appendicitis caused by an Actinomyces israelii mixed infection]
T Mumme1, C Peiper, S Biesterfeld
1Chirurgische Universitäts- und Poliklinik und Aachen, Germany. Torsten.Mumme@post.rwth-aachen.de
Abstract:
We report the rare case of a retrocecal appendicitis in an adult caused by an Actinomyces israelii mixed infection. Suspecting an acute appendicitis the explorative laparotomy was performed. Appendectomy with extensive drainage of the abscess and subsequent high-dose penicillin therapy over several months were the definitive treatment, resulting in complete healing. Special features of clinical symptomatology and problems concerning diagnosis and differential diagnosis are discussed.
Insights
This case report details a rare retrocecal appendicitis in an adult, caused by Actinomyces israelii mixed infection. Treatment involved appendectomy, abscess drainage, and long-term penicillin, leading to complete recovery.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Pathology
Background:
- Retrocecal appendicitis is an uncommon anatomical presentation of acute appendicitis.
- Actinomyces israelii is a rare causative agent of intra-abdominal infections, often associated with actinomycosis.
Observation:
- A rare case of retrocecal appendicitis in an adult patient presenting with atypical symptoms.
- Diagnosis was complicated by the unusual location and mixed infection etiology.
Findings:
- The appendicitis was attributed to a mixed infection involving Actinomyces israelii.
- Surgical intervention (appendectomy, abscess drainage) and prolonged high-dose penicillin therapy were crucial for successful management.
Implications:
- Highlights the importance of considering rare pathogens like Actinomyces israelii in complex appendicitis cases.
- Emphasizes the need for thorough differential diagnosis in retrocecal appendicitis to ensure appropriate treatment.
- Successful management underscores the efficacy of surgical intervention combined with targeted antimicrobial therapy.