Abdominal actinomycosis

Abstract

A case of sigmoid actinomycosis is described and the cases of abdominal actinomycosis presenting at the Manchester Royal Infirmary over the past 20 years are reviewed. The whole problem of abdominal actinomycosis is discussed, with special reference to the sites of infection and mode of treatment. The relevant literature is reviewed.

Pelvic Actinomycosis Presenting as Ureteric and Rectal Stricture

“…It acts as an opportunistic infection, usually with other bacterial invasion. It tends to follow a break in the normal mucosal barrier [1, 4, 5]. More than 50% of the actinomycosis infections occur in the cervicofacial region and only about 20% of the cases are abdominal infections.…”

“…Pelvic actinomycosis is a rare infection caused by filamentous, gram-positive, anaerobic bacteria that are part of the endogenous microflora of the human and animal oro-pharyngeal cavities and become pathogenic when they enter the peritoneal cavity after perforation of appendicitis, perforation of colon or diverticulitis [1, 2]. During the last decades it has become more common in females who use plastic intrauterine contraceptive devices for many years, possibly following oro-genital contact [3].…”

Actinomycosis of the ileocaecal junction

“…Abdominal actinomycosis is the second commonest form of actinomycosis after the cervicofacial form and usually affects the ileocaecal junction, up to 70% in one series. 2 Other reported sites include the stomach, colon, hepatobiliary system and kidneys. 1 A rising incidence of pelvic actinomycosis has been reported due to the use of intrauterine contraceptive devices 3 .…”

“…Surgical treatment is usually undertaken for unsuspecting cases, either presenting with abscesses or sinuses which required drainage, or abdominal masses which required extirpation surgery. Prognosis is excellent with correct antibiotic treatment but recurrence occurs if the duration of antibiotic cover is inadequate 1,2,5 . This lady was put on oral penicillin for twelve months and tolerated the drug well.…”

Periappendiceal Actinomycosis Presenting as Acute Appendicitis

“…Its clinical symptoms are non-specific and include abdominal pain, fever, nausea, vomiting, and diarrhea [3]. If the appendix ruptures, right-sided pain and other symptoms of appendicitis can develop [3][4][5]. A combination of antibiotics and surgical intervention is the treatment of choice for abdominal actinomycosis [6].…”