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Hepatic Actinomycosis in a Patient With Retained Common Bile Duct Stent
Alyssa Grossen1, Michael Magguilli2, Theresa C Thai3
1Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
Abstract:
Primary hepatic actinomycosis is rare, with less than 100 cases reported in English literature. Most of these cases are cryptogenic. We describe a 35-year-old woman who presented with a retained common bile duct stent for 6 years and found to have a hepatic mass with altered perfusion and enhancement, and minimal degree of washout on enhanced cross-sectional imaging. Fine-needle aspiration revealed presence of filamentous bacteria morphologically consistent with Actinomyces species. This report is a demonstration of a rare instance in which a retained biliary stent led to primary hepatic actinomycosis.
Insights
Primary hepatic actinomycosis, a rare liver infection, can develop from retained biliary stents. This case highlights a 6-year retained stent leading to a hepatic mass caused by Actinomyces species.
Area of Science:
- Hepatology
- Infectious Diseases
- Medical Imaging
Background:
- Primary hepatic actinomycosis is an uncommon infection, with fewer than 100 reported cases.
- Most cases are cryptogenic, lacking an identifiable cause.
Observation:
- A 35-year-old woman presented with a hepatic mass.
- Imaging revealed altered perfusion and enhancement, with minimal washout.
- A history of a retained common bile duct stent for six years was noted.
Findings:
- Fine-needle aspiration identified filamentous bacteria consistent with Actinomyces species.
- The hepatic mass was diagnosed as primary hepatic actinomycosis.
Implications:
- This case demonstrates a rare complication of retained biliary stents.
- Retained biliary stents may serve as a nidus for Actinomyces infection in the liver.
- Highlights the importance of considering retained foreign bodies in the differential diagnosis of hepatic masses.
