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[Abdominal actinomycosis]

G Bannura1

  • 1Depto de Cirugia, Universidad de Chile, Hospital Clínico San Borja-Arriarán. Santiago.

Revista Medica De Chile
|November 1, 1994
PubMed
Summary
This summary is machine-generated.

Actinomycosis, a chronic bacterial infection, often presents as a "great pretender" with varied symptoms. Early diagnosis and long-term antibiotic treatment, like penicillin, lead to complete recovery in most abdominal cases.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Gastroenterology

Context:

  • Actinomycosis is a rare, chronic bacterial infection caused by Actinomyces species.
  • Historically, 54 cases reported in Chilean literature over 50 years, with abdominal (51%), pelvic (25.5%), and pulmonary (18.5%) distributions.
  • Focus on 14 cases treated at San Borja Arriaran over 9 years, highlighting abdominal presentations.

Purpose:

  • To review the clinical presentation, diagnosis, and treatment outcomes of actinomycosis cases.
  • To emphasize the diagnostic challenges and varied clinical manifestations of actinomycosis.
  • To assess the efficacy of antibiotic therapy and surgical interventions in managing actinomycosis.

Summary:

  • Seven abdominal actinomycosis cases included 1 parietal and 6 visceral forms, with specific involvement of rectosigmoid and ileocecal regions.

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  • Presentations ranged from giant abdominal masses and fistulas to rectal strictures and tubo-ovarian abscesses with colonic involvement.
  • Actinomyces israelii confirmed in 5 cases; treatment involved 6-12 months of penicillin combined with tetracycline or amoxicillin, achieving complete recovery.

    • Impact:

    • Long-term antibiotic therapy (penicillin-based) resulted in complete and permanent recovery for visceral actinomycosis.
    • Surgical intervention (colonic resection, colostomy) was necessary in some cases due to complications or iatrogenic damage, with patients becoming asymptomatic post-treatment.
    • Highlights actinomycosis as a diagnostic challenge due to its diverse presentations, underscoring the importance of considering it in complex abdominal conditions.