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[Abdominal actinomycosis: four cases]
N Ghannouchi Jaafoura1, N Kaabia, M Khalifa
1Service de Médecine Interne et Maladies Infectieuses, Hopital Fahrat Hached, Sousse, Tunisie.
Abstract:
The abdominal actinomycosis (AA) is a rare and often unrecognised suppurative chronic illness. It is caused by an anaerobic Gram positive bacteria, Actinomyces israelii. Abdominal actinomycosis is responsible for pseudotumoral syndrome often leading, to a large and mutilating surgery whereas a prolonged treatment by antibiotics would have permitted to cure the disease. The diagnosis is obtained generally from anatomopathologic exam. We report four cases of abdominal actinomycosis being revealed by a pseudotumoral syndrome. The diagnosis was only made after surgery. In spite of an active treatment by antibiotics during several months, two of our patients had a relapse of the infectious process. These four observations confirm the diagnostic and therapeutic difficulties previously reported by other authors.
Insights
Abdominal actinomycosis (AA) is a rare bacterial infection often misdiagnosed as a tumor. Early antibiotic treatment is crucial for cure, preventing extensive surgery and potential relapse.
Area of Science:
- Infectious Diseases
- Microbiology
- Surgical Pathology
Background:
- Abdominal actinomycosis (AA) is a rare, chronic suppurative illness caused by Actinomyces israelii.
- AA often presents as a pseudotumoral syndrome, leading to misdiagnosis and unnecessary surgery.
- Diagnosis is typically confirmed via anatomopathological examination.
Observation:
- This report details four cases of AA presenting with pseudotumoral syndrome.
- Diagnosis in these cases was only established post-operatively.
- Two patients experienced relapse despite prolonged antibiotic therapy.
Findings:
- AA frequently mimics malignancy, complicating diagnosis and treatment.
- Surgical intervention is often performed before a definitive diagnosis is reached.
- Relapse can occur even after months of appropriate antibiotic treatment.
Implications:
- Highlights the diagnostic challenges of abdominal actinomycosis.
- Emphasizes the importance of considering AA in pseudotumoral syndromes.
- Underscores the need for prompt and prolonged antibiotic therapy to prevent surgical complications and relapse.
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