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[Actinomycosis of the buttock]
S Maradeix1, Y Scrivener, E Grosshans
1Clinique Dermatologique, des Hôpitaux Universitaires de Strasbourg.
Annales De Dermatologie Et De Venereologie
|July 1, 2005
Summary
This case report details a rare instance of cutaneous actinomycosis on the buttocks, presenting as a pseudo-tumor. Diagnosis was confirmed via biopsy and culture, leading to successful treatment with surgery and antibiotics.
Area of Science:
- Medical Microbiology
- Dermatology
- Surgical Pathology
Background:
- Cutaneous actinomycosis is a rare bacterial infection, typically originating perianally.
- This report focuses on an unusual presentation of actinomycosis on the buttocks, mimicking a tumor.
Observation:
- A 69-year-old woman presented with a large, ulcerated mass on her buttock.
- Initial imaging suggested liposarcoma due to soft tissue and muscle invasion.
- Histopathology revealed characteristic bacterial grains within a cholesterol granuloma.
Findings:
- Bacterial culture identified Actinomyces gerencseriae as the causative agent.
- The lesion's pseudo-sarcomatous appearance led to diagnostic challenges.
- The actinomycosis originated from a previous appendicitis, presenting as a delayed-onset posterior fistula.
Implications:
- This case highlights the importance of considering actinomycosis in the differential diagnosis of buttock masses, especially those with a history of abdominal issues.
- Delayed diagnosis can occur due to the unusual presentation and pseudo-sarcomatous features.
- Successful treatment involves surgical excision and prolonged antibiotic therapy (amoxicillin-clavulanic acid).