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Primary anterior abdominal wall actinomycosis.
A F Hefny1, S Joshi, Y A Saadeldin
1Department of Surgery, Faculty of Medicine and Health Sciences, Al-Ain University, United Arab Emirates.
Singapore Medical Journal
|April 29, 2006
Summary
Actinomycosis, a rare infection, can affect the anterior abdominal wall. This case report details a diabetic man successfully treated with surgical excision and penicillin for abdominal actinomycosis.
Area of Science:
- Medical microbiology
- Surgical pathology
- Infectious diseases
Background:
- Actinomycosis is a chronic bacterial infection typically caused by *Actinomyces israelii*.
- It often affects the cervicofacial region but can occur in other body sites, including the abdomen.
- Anterior abdominal wall actinomycosis is exceptionally rare, posing diagnostic challenges.
Observation:
- A 50-year-old diabetic male presented with a left hypochondrial mass and fever.
- Computed tomography revealed a 2 x 4 cm inflammatory mass of the internal abdominal wall.
- The mass was unresponsive to a week of intravenous antibiotics.
Findings:
- Surgical excision of the abdominal wall mass was performed.
- Microscopic examination confirmed actinomycosis involving deep abdominal muscles.
- The patient received a six-month course of penicillin post-operatively.
Implications:
- This case highlights the importance of considering actinomycosis in the differential diagnosis of abdominal masses, especially in diabetic patients.
- Prompt diagnosis and appropriate treatment, including surgical intervention and prolonged antibiotic therapy, are crucial for favorable outcomes.
- Further research into the pathogenesis and optimal management of abdominal actinomycosis is warranted.