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Abdominal actinomycosis

J R Cintron1, A Del Pino, B Duarte

  • 1Department of Surgery, The West Side Veterans Administration Hospital and Medical Center, Chicago, Illinois 60612, USA.

Diseases of the Colon and Rectum
|January 1, 1996
PubMed
Summary
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Abdominal actinomycosis, a rare infection, can mimic cancer. Diagnosis is challenging, but computed tomography and needle aspiration can guide non-surgical treatment with penicillin, avoiding extensive surgery.

Area of Science:

  • Medical Microbiology
  • Surgical Pathology
  • Diagnostic Imaging

Background:

  • Actinomyces israelii, a commensal bacterium, rarely causes disease.
  • Abdominal actinomycosis presents as masses or abscesses, often mistaken for malignancy.
  • Preoperative diagnosis is difficult, frequently necessitating surgical exploration.

Observation:

  • Two cases of abdominal actinomycosis are presented, involving the sigmoid colon and retroperitoneum.
  • Both cases simulated malignant neoplasms, requiring surgical intervention for diagnosis and treatment.
  • Actinomycotic masses and strictures can present diagnostic challenges, mimicking other pathologies.

Findings:

  • Long-term penicillin treatment is effective for actinomycotic abdominal masses and strictures.

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  • Successful non-surgical management is achievable, obviating the need for surgical resection.
  • Definitive preoperative diagnosis remains a significant challenge in managing actinomycosis.

    • Implications:

    • Computed tomography (CT) is the most valuable diagnostic tool for abdominal actinomycosis.
    • Abdominal actinomycosis typically appears as a contrast-enhancing, multicystic lesion on CT scans.
    • Needle aspiration cytology offers a reliable method for diagnosing suspicious lesions, guiding conservative treatment.