Disseminated Actinomycosis Presenting As a Testicular Mass: A Case Report

Abstract

Actinomycosis of the testicle is a rare clinical entity. A review of the literature reveals only 7 case reports. Patients require prolonged therapy with antibiotics, usually penicillin. Many patients with less severe forms of the disease improve on antibiotics alone. Surgical intervention is reserved for confirming the diagnosis, treatment of abscesses, excision of sinus tracts and drainage. We report case 8 in the literature and review the previous reports.

Primary testicular actinomycosis mimicking metastatic tumor

“…Usually, unilateral adnexal tissue is involved and characterized by tissue destruction, often multiple, abscesses formation 8 . Meanwhile, in other genitourinary organs, Actinomyces infections are uncommon and sporadic reports on the testis, 1–5 hydrocele wall, 6 urinary bladder, 9 kidney, 10 urachal remnants 11 and paraurethral region 12 have been documented.…”

“…We have so far found only nine documented cases of Actinomyces affecting testes in the English literature 1–5 . Among them, four cases were associated with malignancies, including three prostatic carcinoma 1,2 , 6 and one sigmoid colon adenocarcinoma 4 .…”

“…Of these, two patients; one with prostatic carcinoma 2 and one with sigmoid colon adenocarcinoma, 4 died of malignancies, even though these patients had undergone orchiectomies. Of the remaining five cases unassociated with any malignancy, three were cured after orchiectomy and no follow up data were available concerning the other two cases 5 . In total, only three out of nine patients had been administered penicillin following orchiectomy.…”

“…Primary testicular actinomycosis is an extremely rare disease and presents with testicular abscess or mass 1–6 . Preoperative diagnosis is difficult, but important, as this disease is treatable.…”

Die Actinomykose des Colon als seltene Differentialdiagnose des Coloncarcinoms

“…In der Regel tritt die Infektion bei Kindern unter 10 Jahren nicht auf. So fan-den sich Actinomykosen schon im Kleinhirn, in der Schilddrüse, im Hoden oder der Harnblase [8,9,13,23]. Zu 15 % ist die Thoraxregion betroffen.…”