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A Rare Complication of Actinomyces Abdominal Infection: A Case Report
Lígia Freire1, Cláudia Santos1, Frederico Duarte2
1General Surgery, Hospital Pedro Hispano, Matosinhos, PRT.
Abstract:
Intraabdominal infection by Actinomyces species, although a rare condition, usually occurs after a disruption of the mucosal barrier in a peritoneal organ. This infection is characterized by the development of an extended and persistent inflammatory and fibrotic reaction that can be mistaken for other pathogens or different etiologies, like tumors or inflammatory diseases. It can present as an abscess, a stricturing tissue with multiple adhesions, and/or a fistulization. Early diagnosis, targeted and prolonged antimicrobial therapy, and optimal drainage when indicated, are the key to success. The authors present a case where laparotomic hysterectomy was complicated by a superficial and an organ/space surgical site infection due to Actinomyces with a posterior developing of a colo-vaginal fistula that was treated surgically.
Insights
Actinomyces intraabdominal infections are rare but can mimic tumors. Prompt diagnosis and treatment are crucial for managing these persistent inflammatory conditions, especially after surgery.
Area of Science:
- Microbiology
- Surgical Pathology
Background:
- Intraabdominal Actinomyces infections are uncommon, typically arising from mucosal barrier breaches in peritoneal organs.
- These infections present as persistent inflammation and fibrosis, potentially mimicking tumors or other diseases.
Observation:
- Actinomyces infections can manifest as abscesses, strictures with adhesions, or fistulas.
- A case of post-hysterectomy surgical site infection by Actinomyces led to a colo-vaginal fistula.
Findings:
- The presented case involved a superficial and organ/space surgical site infection due to Actinomyces following laparotomic hysterectomy.
- A subsequent colo-vaginal fistula developed and was successfully treated surgically.
Implications:
- Early diagnosis and appropriate management, including antimicrobial therapy and surgical drainage, are vital for successful outcomes.
- Recognizing Actinomyces as a potential cause of complex intraabdominal infections and post-surgical complications is essential for clinicians.
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