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[Actinomycosis: value of percutaneous drainage of intra-abdominal abscesses]
J F Richard1, K Slim, M Alexandre
1Service de Chirurgie Générale et Digestive, Hôtel-Dieu, Clermont-Ferrand.
Abstract:
Abdominal actinomycosis was localized in the liver with intra-abdominal abscesses. The disease had evolved for several years before diagnosis. Percutaneous interventional radiology allowed taking biopsies which confirmed the diagnosis. Percutaneous drainage of the intra-abdominal abscesses with antibiotherapy was successful without iterative surgery.
Insights
Abdominal actinomycosis, a rare infection, was successfully treated in the liver using percutaneous drainage and antibiotics. This minimally invasive approach avoided the need for repeated surgeries, offering a new treatment option.
Area of Science:
- Medical Microbiology
- Surgical Pathology
- Interventional Radiology
Background:
- Abdominal actinomycosis is a rare, chronic bacterial infection often presenting with vague symptoms, leading to delayed diagnosis.
- The liver and intra-abdominal abscesses are common sites for actinomycosis, posing diagnostic and therapeutic challenges.
- Traditional management often involves prolonged antibiotic courses and extensive surgical intervention.
Observation:
- A patient presented with a multi-year history of abdominal actinomycosis localized to the liver, complicated by intra-abdominal abscesses.
- Percutaneous interventional radiology techniques were employed for diagnostic biopsy and abscess drainage.
- Microbial analysis of biopsies confirmed Actinomyces species as the causative agent.
Findings:
- Percutaneous biopsy successfully confirmed the diagnosis of abdominal actinomycosis.
- Image-guided percutaneous drainage of intra-abdominal abscesses was performed.
- Combined percutaneous drainage and a course of antibiotherapy led to a successful clinical outcome.
- The patient recovered without requiring further surgical procedures.
Implications:
- Percutaneous interventional radiology offers a minimally invasive and effective approach for diagnosing and managing abdominal actinomycosis.
- Image-guided drainage combined with appropriate antibiotherapy can obviate the need for surgery in select cases of abdominal actinomycosis.
- This case highlights the importance of considering actinomycosis in the differential diagnosis of chronic intra-abdominal infections and abscesses.