Yonsei Med J.  2009 Aug;50(4):555-559. 10.3349/ymj.2009.50.4.555.

Clinical Features of Abdominopelvic Actinomycosis: Report of Twenty Cases and Literature Review

• Choi MM
• Beak JH
• Lee JN
• Park S
• Lee WS

• KMID: 1758616
• DOI: http://doi.org/10.3349/ymj.2009.50.4.555

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.

Keyword

Actinomycosis; surgery; intrauterine device

MeSH Terms

Abdominal Pain/*etiology/microbiology
Actinomycosis/*diagnosis/pathology
Adult
Aged
Female
Humans
Intrauterine Devices
Male
Middle Aged
Peritonitis/pathology/surgery
Young Adult

Figure

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  Fig. 1 10.3 × 9.3 cm ovoid mass on the serosal surface of the cecum and ascending colon with ulceration. The cut surface demonstrates typical light gray color with necrosis.

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  Fig. 2 (A) A actinomycotic abscesses containing sulfur granules with radiating filaments (H & E, ×100). (B) A magnified view of the characteristic sulfur granule (H & E, ×200).

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