[en] Abdominal actinomycosis is a rare infectious disease caused by Actinomyces israelii, a gram-positive anaerobic saprophyte germ that is a normal inhabitant of the upper intestinal tract in humans. Actinomyces israelii rarely cause abdominal infections or actinomycosis. Abdominal actinomysosis is characterised by fistulae and abscesses and may mimic cancer or inflammatory bowel disease. Abdominal actinomycosis is difficult to diagnose preoperatively, and often require surgical removal of the diseased tissue, allowing pathologists for giving the definitive diagnosis, revealed by characteristic "sulfur granules". The authors report herein the case of a 47-year-old man who presented with diarrhoea and abdominal pain. Abdominal computed tomography evoked complicated inflammatory bowel disease and surgical procedure was decided. Laparoscopic exploration did not provide further significant information, and laparotomy with diseased bowel resection was performed. Pathology demonstrated "sulfur granules" and allowed the diagnosis of abdominal actinomycosis. This case demonstrated that abdominal actinomycosis should be included in the differential diagnosis when computed tomography shows an infiltrative and inflammatory mass.
Disciplines :
Gastroenterology & hepatology Surgery
Author, co-author :
Postal, Alain ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Detry, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Louis, Edouard ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Hardy, Nicole
Belaiche, Jacques ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Jacquet, Nicolas
Language :
English
Title :
Ileo-caecal actinomycosis: Report of a case simulating complicated inflammatory bowel disease
Cintron J.R., Del Pinto A., Duarte B., Wood D. (1996) Abdominal actinomycosis: Report of two cases and review of the literature. Dis. Colon Rectum 39:105-108.
Mast P., Vereecken L., Van Loon C., Hermans M. (1991) Actinomycosis ot the ano-rectum: A rare infection mimicking carcinomatosis. Acta Chir. Belg. 91:150-154.
Richards R.J., Grayer D. (1989) Actinomycosis: A rare cause of vesicocolic fistula. Am. J. Gastroenterol. 84:677-679.
Klaaborg K.E., Krongorg O., Olsen H. (1985) Entercutaneous fistulization due to Actinomyces odontolyticus: Report of a case. Dis. Colon Rectum 28:526-527.
Meyer P., Nwariaku O., Mcclelland R.N., Gibbons D., Leach F., Sagalowsky I.A., Simmang C., Jeyarajah D.R. (2000) Rare presentation of actinomycosis as an abdominal mass: Report of a case. Dis. Colon Rectum 43:872-875.
Yeguez J.F., Martinez S.A., Sands L.R., Hellinger M.D. (2000) Pelvic actinomycosis presenting as malignant large bowel obstruction: A case report and a review of the literature. Am. Surg. 66:85-90.
Thompson J.R., Watts R., Thompson W.C. (1982) Actinomycetoma masquering as an abdominal neoplasm. Dis. Colon Rectum 25:368-370.
Uchiyama N., Ishikawa T., Miyakawa K., Iinuma G., Nakajima H., Ushio K., Yokota T., Akasu T., Shimoda T. (1997) Abdominal actinomycosis: Barium enema and computed tomography findings. J. Gastroenterol. 32:89-94.
Ha H.K., Lee H.J., Kim H., Ro H.J., Park Y.H., Cha S.J., Shinn K.S. (1993) Abdominal actinomycosis: CT findings in 10 patients. Am. J. Roentgenol. 161:791-794.
Goldwag S., Abbitt P.L., Watts B. (1991) Case report: Percutaneous drainage of periappendiceal actinomycosis. Clin. Radiol. 44:422-424.