Pelvic Actinomycosis Presenting as Malignant Large Bowel Obstruction: A Case Report and a Review of the Literature

Yeguez, Jose; Martinez, Sergio A.; Sands, Laurence R.; Hellinger, Michael D.

doi:10.1177/000313480006600118

Cited by 84 publications

(6 citation statements)

References 31 publications

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“…3,6 Abdominal actinomycosis accounts for 20%-30% of all actinomycosis infections. 11 The disease progresses slowly and can present with nonspecific symptoms such as lower abdominal pain, fatigue, fever, weight loss, and abdominal distension with ascites with or without a palpable mass. Our patient experienced symptoms of abdominal distention, fatigue, and malaise a month before appearing in the emergency department.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Bacterial Peritonitis Because of Actinomyces

Everett,

Kheraj,

Redfield

et al. 2024

ACG Case Rep J

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Actinomycosis is a rare chronic granulomatous disease that manifests with nonspecific symptoms of abdominal pain, anorexia, and weight loss. The disparity in the presentation of this condition presents a tremendous diagnostic challenge. There are few reports of Actinomyces species causing spontaneous bacterial peritonitis without previous localized masses or abscesses have been published. We provide a case of spontaneous bacterial peritonitis secondary to Actinomyces species in a 46-year-old woman with uterine fibroids and a lack of preceding abscess. Although rare, spontaneous bacterial peritonitis because of Actinomyces should be considered in differential in female patients without pre-existing liver disease presenting with spontaneous bacterial peritonitis.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Bacterial Peritonitis Because of Actinomyces

Everett,

Kheraj,

Redfield

et al. 2024

ACG Case Rep J

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“…Abdominal Actinomycosis usually affects the appendix and ileus [15]. Factors that predispose to infection, include trauma, neoplasia, recent surgery, perforated viscus, as well as the use of intrauterine contraceptive devices [16]. Patient with presents with an indolent course of symptoms such as fever weight loss, fatigue and associated abdominal pain.…”

Section: Abdominal Actinomycosismentioning

confidence: 99%

Actinomycosis: Diagnosis, Clinical Features and Treatment

Cantres-Fonseca¹,

Vando-Rivera²,

Fonseca-Ferrer³

et al. 2022

Actinobacteria - Diversity, Applications and Medical Aspects

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Actinomycosis is a filamentous bacterium that forms part of the normal human flora of the gastrointestinal, oropharynx and female genitalia. This indolent infection is characterized by abscess formation, widespread granulomatous disease, fibrosis, cavitary lung lesions and mass-like consolidations, simulating an active malignancy or systemic inflammatory diseases. It is subacute, chronic and variable presentation may delay diagnosis due to its capability to simulate other conditions. An accurate diagnostic timeline is relevant. Early diagnosis of pulmonary actinomycosis decreases the risk of indolent complications. Proper treatment reduces the need for invasive surgical methods. Actinomycosis can virtually involve any organ system, the infection spread without respecting anatomical variables as metastatic disease does, making malignancy an important part of the differential diagnosis. As it is normal gastrointestinal florae, it is difficult to cultivate, and share similar morphology to other organisms such as Nocardia and fungus. It is often difficult to be identified as the culprit of disease. Its true imitator capability makes this infectious agent a remarkable organism within the spectra of localized and disseminated disease. In this chapter, we will discuss different peculiarities of actinomycosis as an infectious agent, most common presentation in different organ systems, and challenging scenarios.

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“…There are a few cases reported suggesting unusual pathologic presentation of actinomycosis 6 , 7 , 10 – 12 . Since the clinical presentation of abdominal actinomycosis is of nonspecific symptoms and signs, that can mimic other diseases 13 , less than 10% of appendiceal actinomycosis cases are diagnosed before surgery due to the need of histological confirmation of the specimen for definitive diagnosis 1 , 14 .…”

Section: Introductionmentioning

confidence: 99%

Appendiceal actinomycosis mimicking malignant tumor: a rare case report

Khabyeh-Hasbani,

Zino,

Dima

et al. 2024

Annals of Medicine &Amp; Surgery

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Introduction: Actinomycosis is an uncommon bacterial infection caused by Actinomyces bacteria that typically progresses slowly and leads to the formation of masses. Although it commonly affects the cervicofacial area, about 20% of cases occur in the abdominopelvic region. Because the disease can be mistaken for a tumor due to its infiltrative mass-like nature on imaging, over 90% of cases are only diagnosed following surgery and histological confirmation. This report describes a case of an appendicular mass, initially suspected to be a malignant tumor, but eventually diagnosed as appendiceal actinomycosis. Presentation of Case: Upon initial presentation, a 53-year-old woman with type II diabetes mellitus and no prior surgical history, displayed abnormal appendiceal uptake during a PET-CT scan conducted for a suspected spinal tumor. Colonoscopy did not indicate any notable observations, and the patient chose to defer immediate action. Several months later, a CT scan revealed an increased mass-like appearance of the appendix compared to the previous PET-CT scan. After multidisciplinary discussions, a right laparoscopic hemicolectomy was recommended due to suspected malignancy. However, histological staining on microscopy confirmed actinomycosis originating from the appendix. Discussion: Chronic appendicitis with radiologic features similar to appendiceal carcinoma, or abdominal masses located in the ileocecal area, in patients with or without a previous surgical history should raise suspicion of actinomycosis. Conclusion: Appendiceal actinomycosis should be considered in the differential diagnosis in the etiology of chronic appendicitis mimicking appendiceal carcinoma. Awareness and accurate diagnosis of appendiceal actinomycosis can prevent unnecessary extended surgery as was performed in this case.

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Pelvic Actinomycosis Presenting as Malignant Large Bowel Obstruction: A Case Report and a Review of the Literature

Cited by 84 publications

References 31 publications

Spontaneous Bacterial Peritonitis Because of Actinomyces

Spontaneous Bacterial Peritonitis Because of Actinomyces

Actinomycosis: Diagnosis, Clinical Features and Treatment

Appendiceal actinomycosis mimicking malignant tumor: a rare case report

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