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Primary actinomycosis in the liver.

M Hisaoka¹, T Nakamura, J Haratake

¹Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

Journal of UOEH

|March 1, 1991

Summary

This case report details a rare instance of liver actinomycosis, a bacterial infection, diagnosed histopathologically in a 71-year-old female. The findings highlight the importance of considering this infection even without typical clinical signs.

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Area of Science:

Medical Microbiology
Pathology
Hepatology

Background:

Actinomycosis is a rare bacterial infection typically affecting the cervicofacial or thoracic regions.
Primary hepatic actinomycosis is exceptionally uncommon, presenting diagnostic challenges.
This case involves a 71-year-old female presenting with choledocholithiasis.

Observation:

A 2 cm liver nodule was discovered during surgery for gallstones.
Histopathological examination revealed an abscess-forming suppurative inflammation with fibrosis.
Microscopic findings included eosinophilic radiate granules with peripheral clubs.

Findings:

Gram-positive, branched, filamentous bacilli were identified using Brown-Brenn staining.
Acid-fastness of the bacilli was confirmed by a modified Ziehl-Neelsen method.

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The histological and microbiological features were consistent with hepatic actinomycosis.

Implications:

This case underscores the need for histopathological confirmation in diagnosing rare infections.
It expands the understanding of the clinical spectrum and rare presentations of actinomycosis.
Early and accurate diagnosis is crucial for effective management of hepatic actinomycosis.