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Jabi R, Ramdani H, Elmir S, Elmejjati F, Serji B, El Harroudi T, Bouziane M. Pseudotumoral Actinomycosis Mimicking Malignant Colic Disease: A Case Report and Literature Review. Visc Med 2020; 36:333-337. [PMID: 33005660 DOI: 10.1159/000502895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 08/22/2019] [Indexed: 01/16/2023] Open
Abstract
Abdominal actinomycosis is a rare, chronic, and often unrecognized suppurative disease. It is caused by an anaerobic gram-positive bacterium, most commonly Actinomyces israeli. Colonic actinomycosis is rarely reported and may be responsible for a pseudotumoral syndrome leading, in the suspicion of malignancy, to a large and mutilating excisional surgery. It is usually the histopathological examination of the surgical specimens that accurately corrects the diagnosis. Here, we report a rare case of a colic actinomycotic involvement taking a pseudotumoral form. The diagnosis was made based on the pathological examination of the surgical piece. Intravenous and then adjuvant oral penicillin G treatment has allowed a favorable clinical evolution. This observation illustrates the preoperative diagnostic difficulties of this rare disease.
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Affiliation(s)
- Rachid Jabi
- General Surgery Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Hanae Ramdani
- Radiology Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Siham Elmir
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Fouad Elmejjati
- Radiotherapy Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Badr Serji
- General Surgery Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Tijani El Harroudi
- General Surgery Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Mohammed Bouziane
- General Surgery Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
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Lim DR, Hur H, Min BS, Baik SH, Kim NK. Intrauterine Contraceptive Device-Related Actinomycosis Infection Presenting as Ovarian Cancer with Carcinomatosis. Surg Infect (Larchmt) 2014; 15:826-8. [DOI: 10.1089/sur.2013.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dae Ro Lim
- Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyuk Hur
- Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Byung Soh Min
- Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Hyuk Baik
- Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Nam Kyu Kim
- Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
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Sung HY, Lee IS, Kim SI, Jung SE, Kim SW, Kim SY, Chung MK, Kim WC, Oh ST, Kang WK. Clinical features of abdominal actinomycosis: a 15-year experience of a single institute. J Korean Med Sci 2011; 26:932-7. [PMID: 21738348 PMCID: PMC3124725 DOI: 10.3346/jkms.2011.26.7.932] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 04/25/2011] [Indexed: 11/20/2022] Open
Abstract
This study was designed to evaluate the clinical features of abdominal actinomycosis and to assess its therapeutic outcome. We reviewed patients with abdominal actinomycosis in Seoul St. Mary hospital, between January 1994 and January 2010. Twenty-three patients (5 male and 18 female, mean age, 47.8 yr; range, 6-75 yr), with abdominal actinomycosis were included. Emergency surgery was performed in 50% due to symptoms of peritonitis. The common presentation on preoperative computerized tomography was a mass with abscess, mimicking malignancy. The mean tumor size was 7.0 cm (range, 2.5-10.5). In all patients, actinomycotic masses were surgically removed. Mean duration of hospital stay was 17.8 days (range, 5-49). Long term oral antibiotic treatment (mean 4.2 months; range, 0.5-7.0 months) were administered to all patients. All patients were free of recurrence after a median follow up of 30.0 months (mean 35.5 ± 14.8 months, range, 10.0-70.0 months); recurrence was not seen in any patient. In conclusion, abdominal actinomycosis should be included as a differential diagnosis when an unusual abdominal mass or abscess presents on abdominal CT. Assertive removal of necrotic tissue with surgical drainage and long term antibiotic treatment provide a good prognosis in patients with actinomycosis.
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Affiliation(s)
- Hye Young Sung
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
- Health Improvement Center, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - In Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sang Il Kim
- Division of Infection, Department of Internal Medicine, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seung Eun Jung
- Department of Radiology, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sang Woo Kim
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - Su Young Kim
- Department of Pathology, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - Mun Kyung Chung
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
- Health Improvement Center, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - Won Chul Kim
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - Seong Tack Oh
- Department of Surgery, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - Won Kyung Kang
- Department of Surgery, Seoul St. Mary Hospital, the Catholic University of Korea College of Medicine, Seoul, Korea
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Choi MM, Beak JH, Lee JN, Park S, Lee WS. Clinical features of abdominopelvic actinomycosis: report of twenty cases and literature review. Yonsei Med J 2009; 50:555-9. [PMID: 19718405 PMCID: PMC2730619 DOI: 10.3349/ymj.2009.50.4.555] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 11/01/2008] [Accepted: 11/10/2008] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Intrabdominal 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 METHODS We retrospectively analyzed 22 patients with intrabdominal actinomycosis between January 2000 and January 2006. RESULTS There 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. CONCLUSION Intrabdominal 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.
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Affiliation(s)
- Myung-Min Choi
- Department of Surgery, Gil Medical Center, Gachon University of Medicine and Science, Seoul, Korea
| | - Jeong Heum Beak
- Department of Surgery, Gil Medical Center, Gachon University of Medicine and Science, Seoul, Korea
| | - Jung Nam Lee
- Department of Surgery, Gil Medical Center, Gachon University of Medicine and Science, Seoul, Korea
| | - Sanghui Park
- Department of Pathology, Gil Medical Center, Gachon University of Medicine and Science, Seoul, Korea
| | - Won-Suk Lee
- Department of Surgery, Gil Medical Center, Gachon University of Medicine and Science, Seoul, Korea
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Baierlein SA, Wistop A, Looser C, Peters T, Riehle HM, von Flüe M, Peterli R. Abdominal actinomycosis: a rare complication after laparoscopic gastric bypass. Obes Surg 2007; 17:1123-6. [PMID: 17953250 DOI: 10.1007/s11695-007-9189-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A 33-year-old, morbidity obese woman underwent a laparoscopic Roux-en-Y gastric bypass in November 2004. She presented 18 months later with a history of recurrent pain in the upper region of the abdomen and severe vomiting. Radiologic and endoscopic evaluations revealed wall thickening in the transverse colon and a solid tumor near the liver. Therefore, a sonography-guided biopsy of the tumor was performed. Cytopathological examination revealed actinomycosis. Thus, therapy with penicillin was started, after which the parameters associated with the infection decreased. The symptoms persisted, however, and the decision was made to operate on the patient to resect the abdominal masses. Nearly 90% of the masses could be removed. Histological analysis showed a fibro-productive inflammation with an actinomycotic etiology. Antibiotic therapy with penicillin was continued for 6 months. Actinomycosis must be considered in the differential diagnosis of patients with abdominal mass, wall thickening of the intestine, and other such symptoms, including abdominal pain following bariatric surgery, even many years after the intervention.
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Louzi A, Rifki SE, Benamar Y, Attari M, Kafih M, Zerouali NO. Actinomycose colique : à propos d’un cas et revue de la littérature. ACTA ACUST UNITED AC 2005; 130:101-3. [PMID: 15737322 DOI: 10.1016/j.anchir.2004.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2003] [Accepted: 11/09/2004] [Indexed: 11/20/2022]
Abstract
Actinomycosis is a chronic granulomatosis infection caused by a Gram positive anaerobic bacteria, Actinomyces. Abdominal localizations are rare and simulated a malignant process. The difficulties of diagnosis are usually leading to surgical resection. We report a colonic actinomycosis case of a 62-year-old woman with a abdominal tumor and diagnosed after surgical resection.
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Affiliation(s)
- A Louzi
- Service des urgences chirurgicales viscérales, CHU Ibn-Rochd, 21, ESSALAMA 3, Groupe 9, Bloc N Casablanca, Maroc.
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Benjelloun N, Rifki Jai S, Benamar MY, Aisse L, Kafih M, Ridai M, Zeroualli ON. Actinomycose colique. Med Mal Infect 2004; 34:233-4. [PMID: 16235603 DOI: 10.1016/j.medmal.2004.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- N Benjelloun
- Service de chirurgie des urgences viscérales, CHU de Ibn-Rochd, Casablanca, Maroc.
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Abstract
Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the last ten years. We report three cases of abdominal actinomycosis and a literature review of the last eight years. All three patients were diagnosed by means of histopathologic examination only. In one case, an intrauterine device (IUD) was associated with the infection. Therapy consisted of surgical resection of the inflammatory, infected tissue, and long-term antibiotic therapy. All patients are free of recurrence. Abdominal actinomycosis should be included in the differential diagnosis of an abdominal pathology of insidious onset, especially when an IUD is in place. Even when infection had spread extensively, combined operative and antibiotic therapy cured most of the cases.
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