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Colecisitis y pancreatitis actinomicóticas: informe de un caso inusual
Carlos Eduardo Brantis-de-Carvalho1, Sara Mohrbacher1, Juliana Valéria Souza Framil2
1Department of Internal Medicine, Oswaldo Cruz German Hospital, São Paulo, SP, Brazil.
The American journal of case reports
|February 10, 2026
Resumen
La actinomycosis, una infección bacteriana rara, fue identificada en la vesícula biliar de un paciente con pancreatitis recurrente y síndrome hemolítico-urémico atípico. El tratamiento condujo a la resolución de la infección y la mejora de la salud.
Área de la Ciencia:
- Gastroenterología y Gastroenterología.
- Enfermedades infecciosas Enfermedades infecciosas.
- Genética La genética.
Sus antecedentes:
- La actinomycosis es una infección bacteriana poco común causada por Actinomyces spp.
- Por lo general, se presenta en las regiones cervicofacial o abdominopelvical, pero puede afectar la vesícula biliar y el páncreas.
- La actinomicosis biliar y pancreática puede imitar otras afecciones, presentando desafíos diagnósticos y terapéuticos.
Objetivo del estudio:
- Para informar un caso de actinomicosis de la vesícula biliar en un paciente con pancreatitis recurrente y síndrome hemolítico-urémico atípico.
- Para investigar el vínculo potencial entre las mutaciones genéticas, la inflamación sistémica y la colonización de Actinomyces.
- Para resaltar las estrategias de diagnóstico y manejo para esta rara presentación.
Principales métodos:
- Informe de caso de una paciente de 26 años de edad.
- El trabajo de diagnóstico incluyó tomografía computarizada, ecografía endoscópica, ecografía abdominal y panel de síndrome hemolítico-urémico atípico.
- Examen histopatológico de la muestra de vesícula biliar después de la colecistectomía.
Principales resultados:
- La histopatología confirmó Actinomyces spp. en la vesícula biliar, presentándose como gránulos de azufre y bacilos con manchas de Gram.
- El paciente tenía mutaciones subyacentes en los genes CFHR3 y CFI, que contribuyen a la microangiopatía trombótica-síndrome urémico hemolítico atípico.
- Los hallazgos de la vesícula biliar incluyeron hiperplasia de la mucosa, fibrosis transmural, histiocitos xantomatosos y senos nasales de Rokitansky-Aschoff.
Conclusiones:
- El manejo quirúrgico (colecistectomía) y la terapia antimicrobiana condujeron a la resolución de la actinomicosis.
- El paciente experimentó una mejora en la salud y no hubo más episodios de pancreatitis en el año siguiente.
- La predisposición genética y la inflamación sistémica probablemente facilitaron la colonización de Actinomyces en la vesícula biliar comprometida.
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