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[Abdominal actinomycosis - 3 case reports and literature overview]
J Majernik1, D Bis, P Hanousek
1Chirurgicke oddeleni Chrudimska nemocnice. pepaa8@gmail.com
Abstract:
The authors present three cases of abdominal actinomycosis that were initially diagnosed as acute appendicitis, an abscess in the left groin and pelvic tumour, probably of gynaecological origin. Definitive diagnosis of abdominal actinomycosis was established as late as postoperatively. Abdominal actinomycosis is a chronic, infectious disease characterized most frequently by non-specific symptoms such as abdominal pain, fever, vomiting, bowel obstruction, weight loss, sometimes palpable resistance, and leukocytosis [1-9]. Diagnosis may be difficult and needs to be taken into account, especially in patients with risk factors.
Insights
Abdominal actinomycosis is a challenging diagnosis often mistaken for appendicitis or pelvic tumors. Early consideration of this chronic infection is crucial for timely and accurate diagnosis in patients with risk factors.
Area of Science:
- Medical Microbiology
- Surgical Pathology
- Infectious Diseases
Background:
- Abdominal actinomycosis is a rare, chronic bacterial infection caused by Actinomyces species.
- It often presents with vague, non-specific symptoms, mimicking common surgical emergencies.
- Risk factors include poor dental hygiene, abdominal surgery, and intrauterine devices.
Observation:
- Three cases are presented where abdominal actinomycosis was initially misdiagnosed.
- Presenting symptoms included acute appendicitis, a left groin abscess, and a pelvic tumor.
- Definitive diagnosis was only achieved postoperatively in all cases.
Findings:
- The study highlights the diagnostic difficulty of abdominal actinomycosis due to its non-specific clinical presentation.
- Commonly observed symptoms include abdominal pain, fever, vomiting, bowel obstruction, weight loss, and leukocytosis.
- Histopathological examination is essential for confirming the diagnosis, often revealing characteristic sulfur granules.
Implications:
- Clinicians should maintain a high index of suspicion for abdominal actinomycosis in patients with persistent, unexplained abdominal symptoms.
- Considering this diagnosis, especially in the presence of risk factors, can lead to earlier detection and appropriate treatment.
- Prompt diagnosis and treatment are vital to prevent complications and improve patient outcomes in abdominal actinomycosis.
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