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Hepatic actinomycosis - A potential mimicker of malignancy
Patrick Murphy1, Winnie A Mar1, David Allison2
1University of Illinois at Chicago, Department of Radiology, 1740 W Taylor St, Rm 2483, (MC 931), Chicago, IL 60612, USA.
Radiology Case Reports
|November 26, 2019
Summary
This case report details a rare instance of primary hepatic Actinomycosis, a bacterial infection. Genomic analysis was crucial for diagnosis when traditional methods failed, highlighting diagnostic challenges.
Area of Science:
- Infectious Diseases
- Microbiology
- Hepatology
Background:
- Actinomycosis is a rare granulomatous infection caused by Actinomycetaceae bacteria.
- Typically affects cervicofacial regions, but abdominal involvement is less common, often linked to gastrointestinal mucosal disruption.
- Presents with non-specific symptoms like fever and myalgias.
Observation:
- A patient with rectal cancer presented with non-specific symptoms like fever and myalgias.
- CT and ultrasound revealed multiple hepatic lesions suspicious for metastases or abscesses.
- Initial biopsy was non-diagnostic; subsequent resection confirmed an abscess, but cultures were negative.
Findings:
- Genomic polymerase chain reaction (PCR) analysis identified Actinomyces DNA in the hepatic lesion.
- This confirmed a rare case of primary hepatic Actinomycosis.
Implications:
- This case underscores the diagnostic difficulties associated with Actinomycosis due to its varied presentations.
- Genomic techniques like PCR are crucial for identifying Actinomyces when traditional methods fail.
- Highlights the importance of considering rare infections in patients with complex medical histories and ambiguous imaging findings.
