Omental actinomycosis imitating a foreign body infection

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Surgical Pathology

Background:

• Actinomycosis is a rare, chronic infection caused by anaerobic Gram-positive bacteria.
• Cervicofacial infections are most common, but abdominal actinomycosis presents diagnostic challenges, often mimicking malignancy or tuberculosis.
• Omental actinomycosis is particularly rare and can present insidiously.

Purpose of the Study:

• To report a rare case of omental actinomycosis.
• To highlight the diagnostic difficulties of abdominal actinomycosis.
• To demonstrate the efficacy of antibiotic treatment following surgical diagnosis.

Main Methods:

• Histopathologic examination of surgically removed tissue for sulfur granules.
• Clinical presentation and diagnostic imaging (computed tomography).
• Treatment with oral doxycycline and clinical follow-up.

Main Results:

• Omental actinomycosis was diagnosed based on characteristic sulfur granules.
• The condition mimicked a foreign body or malignancy preoperatively.
• Six months of doxycycline treatment led to resolution of inflammation and symptoms, confirmed by imaging at 16 months.

Conclusions:

• Abdominal actinomycosis, including omental involvement, requires a high index of suspicion due to its rarity and mimicry of other conditions.
• Histopathologic confirmation of sulfur granules is crucial for diagnosis.
• Long-term antibiotic therapy, such as doxycycline, is effective in treating actinomycosis.