A Complicated Thread: Abdominal Actinomycosis in a Young Woman with Crohn Disease

Area of Science:

• Gastroenterology
• Infectious Diseases
• Microbiology

Background:

• Crohn disease is a chronic gastrointestinal inflammatory disorder with common complications like abscesses and fistulae.
• Abdominal actinomycosis, caused by *Actinomyces* spp., presents with indolent symptoms and frequent fistulae, mimicking Crohn disease.
• The pathogenesis of abdominal actinomycosis may involve *Actinomyces* translocation from the gut, suggesting a potential association with inflammatory bowel disease.

Observation:

• A case of abdominal actinomycosis was identified in a patient with active Crohn disease.
• The patient presented with symptoms characteristic of both Crohn disease and abdominal actinomycosis.
• Diagnostic challenges arise due to the overlapping clinical presentations.

Findings:

• This report details a rare instance of abdominal actinomycosis co-occurring with active Crohn disease.
• The findings underscore the importance of considering actinomycosis in the differential diagnosis of complex gastrointestinal presentations.
• The case supports the hypothesis that *Actinomyces* infection can occur in the context of inflammatory bowel disease.

Implications:

• Clinicians should maintain a high index of suspicion for abdominal actinomycosis in Crohn disease patients presenting with fistulating complications.
• Accurate diagnosis is crucial for appropriate treatment, as actinomycosis requires specific antimicrobial therapy.
• Further research may elucidate the precise relationship between inflammatory bowel disease and *Actinomyces* infections.