Abdominal wall actinomycosis simulating a malignant neoplasm: Case report and review of the literature

Abstract

Abdominal wall actinomycosis is a rare disease frequently associated with the presence of an intra uterine device. We report on a case of a 47-year-old woman who had used an intrauterine device for many years and had removed it about a month prior to the identification of an abdominal wall abscess caused by Actinomyces israelii . The abscess mimicked a malignancy and the patient underwent a demolitive surgical treatment. The diagnosis was obtained only after histopathological examination. Postoperatively, the patient developed an infection of the wound which was treated with daily medication. The combination of long-term high dose antibiotic therapy with surgery led to successful treatment.

Intra-abdominal actinomycosis, the great mime: case report and literature review

“…In very compromised patients must be carefully assessed the risk-benefit due to a surgical intervetion. A short-term antibiotic treatment can be proposed after debulking surgery [15,16]. Particularly to define a diagnosis laparoscopy approach can be used, but is not safe in case of extensive infection [16].…”

Unusual Presentations of Actinomycosis; Anterior Abdominal Wall and Appendix: Report of Three Cases

“…These findings, however, are not pathognomonic, because other organisms such as Nocardia and Streptomyces may aggregate sulphur granules resembling those found in Actinomycetes infections (7,8). Microbiological isolation of the bacterium from bacterial cultures is usually inconclusive (9). Negative culture rates were reported to be as high as 76% (10).…”

“…In most cases, the diagnosis is often possible after surgical exploration and therefore the treatment becomes complex (9). The treatment of AMC is surgical drainage at the primary site of infection and, if a soft tissue tumor is suspected, a wide primary resection including the surrounding tissue.…”

Periappendiceal Actinomycosis Presenting as Acute Appendicitis

“…First, the clinical presentation of the disease may be acute or the sample may be unobtainable using percutaneous methods. Second, Actinomyces is a Gram-positive, slow-growing, nonacid-fast, anaerobic, and filamentous bacterium that requires specific incubation in special culture medium for at least 7 days [1]. Accordingly, culture results are negative in 76% of cases [12] and excision biopsy for histopathological examination is frequently needed [1].…”

“…A. israelii is an anaerobic Grampositive organism that is normally present in the oral cavity as well as throughout the gastrointestinal tract, female genital tract, and the bronchus [1] that spreads by direct extension across the tissue planes with the formation of multiple abscesses, abundant granulation tissue, and draining sinuses [2]. Actinomycosis occurs most frequently in the cervical facial (50% to 65%), abdominal (20%), and thoracic (15%) regions [1].…”