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

Primary gastric actinomycosis: A rare case report

“…Primary gastric actinomycosis frequently presents as low-grade fever, epigastric pain, weight loss, upper GI bleeding and rarely symptoms of gastric outlet obstruction. [3,12,14] The patient under study presented with similar clinical features suggestive of actinomycosis. She had undergone cholecystectomy six months ago and was diagnosed on histopathological examination as a case of gastric adenocarcinoma later on, both of which are predisposing factors for acquiring abdominal actinomycosis.…”

“…CT findings mostly demonstrate an infiltrative lesion with diffuse gastric wall thickening suggestive of gastric adenocarcinoma or lymphoma. [2,14] Endoscopic findings of the disease may simulate a gastric neoplasm and include submucosal tumor-like or infiltrative lesions and occasionally, mucosal ulceration. In the present case, endoscopic findings revealed elevated surface and two openings containing necrotic material near the lesser curvature of stomach.…”

“…Because of the submucosal localization of the inflammatory process, endoscopic biopsy specimens usually reveal nonspecific inflammatory changes. [14] Out of the twenty four reported cases of primary gastric actinomycosis, only three cases have been diagnosed pre-operatively by histopathological examination of endoscopic biopsy specimens. [9,10,14] In a case reported by Khaleel Al-Obaidy et al, the patient was subjected to upper gastrointestinal endoscopy twice, carried out one week apart.…”

“…[14] Out of the twenty four reported cases of primary gastric actinomycosis, only three cases have been diagnosed pre-operatively by histopathological examination of endoscopic biopsy specimens. [9,10,14] In a case reported by Khaleel Al-Obaidy et al, the patient was subjected to upper gastrointestinal endoscopy twice, carried out one week apart. Actinomycosis was detected by histopathological examination only in the second biopsy which was obtained from an area containing brownish fibrinopurulent inflammatory exudate.…”

“…[7] Primary gastric actinomycosis is extremely rare, with only 24 cases reported till date. [8][9][10][11][12][13][14] The rarity of gastric involvement by Actinomyces spp. has been attributed to the high luminal acidity of stomach, as a result of which, the organisms are either killed or their growth is inhibited.…”