Clinical Features of Abdominopelvic Actinomycosis: Report of Twenty Cases and Literature Review

Abstract

PurposeIntrabdominal actinomycosis is difficult to diagnose preoperatively. This chronic infection has a propensity to mimic many other diseases and may present with a wide variety of symptoms. The aim of this study was to evaluate the characteristic clinical features with review of the literature.Materials and MethodsWe retrospectively analyzed 22 patients with intrabdominal actinomycosis between January 2000 and January 2006.ResultsThere were two men and 20 women with a mean age of 42.8 years (range, 24 - 69). Twelve patients presented with masses or abdominal pain, whereas 3 patients presented with acute appendicitis. The rate of performing an emergency surgery was 50% due to symptoms of peritonitis. The mean size of tumor was 5.5 cm (range, 2.5 - 11.0). Sixty percent (n = 12) of female patients had intrauterine device (IUD). The average time to definite diagnosis was 10.6 days.ConclusionIntrabdominal abdominal actinomycosis must first be suspected in any women with a history of current or recent IUD use who presents abdominal pain. If recognized preoperatively, a limited surgical procedure, may spare the patient from an extensive operation.

Primary gastric actinomycosis: report of a case diagnosed in a gastroscopic biopsy

“…Actinomycosis in human is most commonly caused by Actinomyces israelii [1,3,[21][22][23][24][25][26] which is an endogenous commensal present in the oral and GI-tract flora [9,10,12,22,27]. Actinomycetes typically invade injured mucosa with opportunistic infection occuring if there is a break in the mucosal barrier.…”

“…There are three main forms of actinomycosis, namely, cervicofacial (31%-65%), abdominopelvic (20%-36%) and thoracic (15%-30%) [1][2][3][4]. In abdominopelvic actinomycosis, the appendix and ileocecal region are the most commonly involved sites (65%) [2,3,[5][6][7].…”

Abdominopelvic Actinomycosis Associated With an Intrauterine Device and Presenting With a Rectal Mass and Hydronephrosis: A Troublesome Condition for the Clinician

“…Therefore, abdominal actinomycosis is included in the differential diagnosis with other inflammatory diseases such as ulcerative colitis, Crohn disease, tuberculosis, diverticulitis, and pelvic inflammatory disease. 7 Pelvic actinomycosis recently has become more prevalent. The pathogenesis of pelvic actinomycosis may occur as either an ascending infection from the lower genital tract or spread from an intestinal lesion.…”

“…Therefore, opportunistic infections can occur only in the context of underlying local disease such as trauma, surgery, or a foreign body that penetrates the mucosal barrier. 7 There are 3 main clinicopathologic presentations described, with varied incidence, including cervicofacial, thoracic, and abdominopelvic. [7][8][9][10] Cervicofacial involvement is the most common, and abdominopelvic involvement is second or third in frequency after thoracic disease.…”

“…7 There are 3 main clinicopathologic presentations described, with varied incidence, including cervicofacial, thoracic, and abdominopelvic. [7][8][9][10] Cervicofacial involvement is the most common, and abdominopelvic involvement is second or third in frequency after thoracic disease. 4 Other sites of involvement also have been reported, including the liver, bone, and perianal region.…”