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A Rare Case of Pancreatic Actinomyces
Marguerite Poche1, Kyle Liu1, Codey Pham2
1School of Medicine, Baylor College of Medicine, Houston, TX.
Abstract:
Actinomyces israelii is a filamentous, gram-positive anaerobic bacterium commonly found in the upper gastrointestinal tract, colon, and female genital tract. Rarely, actinomycosis can infect the pancreas most commonly after pancreatic instrumentation, often mimicking malignancy. We describe a case of a 26-year-old woman who presented with epigastric abdominal pain and nausea without prior pancreatic instrumentation. Abdominal imaging demonstrated a mass in the pancreatic head with fine-needle biopsy revealing Actinomyces. The patient was successfully treated with long-term antibiotic therapy resulting in resolution of the mass. Our case emphasizes the importance of considering nonmalignant etiologies in the differential diagnosis of pancreatic masses.
Insights
Actinomyces israelii, a bacterium, can cause pancreatic masses that mimic cancer. This case highlights successful treatment with antibiotics, emphasizing non-malignant causes for pancreatic lesions.
Area of Science:
- Microbiology
- Gastroenterology
- Pathology
Background:
- Actinomyces israelii is a common anaerobic bacterium in the human body.
- Actinomycosis, a rare infection, can affect the pancreas, often mimicking pancreatic cancer, especially after instrumentation.
- Pancreatic masses require a broad differential diagnosis, including infectious etiologies.
Observation:
- A 26-year-old woman presented with epigastric pain and nausea, with imaging revealing a pancreatic head mass.
- The patient had no history of pancreatic instrumentation.
- Fine-needle biopsy confirmed the presence of Actinomyces in the pancreatic mass.
Findings:
- The patient was diagnosed with pancreatic actinomycosis without a history of instrumentation.
- Long-term antibiotic therapy led to the complete resolution of the pancreatic mass.
- This case demonstrates a rare presentation of pancreatic actinomycosis.
Implications:
- Pancreatic actinomycosis should be considered in the differential diagnosis of pancreatic head masses, even without preceding instrumentation.
- Early diagnosis and appropriate antibiotic treatment can lead to favorable outcomes.
- This case underscores the importance of considering infectious causes in pancreatic pathologies that mimic malignancy.
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