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[Abdominal actinomycosis. Three cases]
F Noomene1, K Zouari, W Kallel
1Service de chirurgie générale et digestive EPS F. Bourguiba Monastir 5000 Tunisie.
Background:
Abdominal actinomycosis is a suppurating affection caused by a positive Gram germ, Actinomyces israelii. Manifestations of this rare disease are usually pseudotumoral syndromes leading to surgical exeresis. The diagnosis is obtained from the histologic report.
Cases Report:
We report three cases in all of which this disease presents with tumoral symptoms. The first affected the sigmoïd, the second affected the mesentery and the last affected the greater omentum and abdominal wall. In no case, the diagnosis was done before surgery. In 2 of the cases reported here, the patients had an old, incontrolled intra-uterine device.
Discussion:
From a review of the literature, we observed that the diagnosis of abdominal actinomycosis remains difficult. The radiologic findings are nonspecific. Actinomycosis is treated with prolonged antibiotics, and surgery is only needed in abdominal abscess and fistula.
Conclusion:
Theses observations illustrates the difficulties of the diagnosis of this rare unrecognized disease.
Insights
Abdominal actinomycosis, a rare bacterial infection, often presents as tumors, making diagnosis challenging. Early detection and appropriate antibiotic treatment are crucial for managing this condition.
Area of Science:
- Medical microbiology
- Surgical pathology
- Infectious diseases
Background:
- Abdominal actinomycosis is a rare suppurative infection caused by Actinomyces israelii.
- Clinical manifestations often mimic pseudotumoral syndromes, necessitating surgical intervention.
- Histopathological examination is typically required for definitive diagnosis.
Observation:
- Three cases of abdominal actinomycosis are presented, all exhibiting tumoral symptoms.
- Affected sites included the sigmoid colon, mesentery, and greater omentum with the abdominal wall.
- Preoperative diagnosis was not achieved in any of the reported cases.
- Two patients had a history of an intrauterine device.
Findings:
- Diagnosis of abdominal actinomycosis is challenging due to nonspecific radiologic findings.
- The condition is primarily treated with extended antibiotic courses.
- Surgical intervention is reserved for cases involving abdominal abscess or fistula formation.
Implications:
- These cases highlight the diagnostic difficulties associated with abdominal actinomycosis.
- Increased awareness and consideration of actinomycosis in patients with unexplained abdominal masses are warranted.
- Prompt diagnosis and management can prevent complications and improve patient outcomes.