Human actinomycosis is an infrequent chronic infection caused by gram-positive anaerobic bacteria with predominantly cervicofacial and intestinal manifestation. Retroperitoneal abscess formation displays a very rare localisation and is mostly incidentally diagnosed by histological examination. We report on a 44-year-old woman with left-sided flank pain and retroperitoneal abscess formation diagnosed by CT scan. Case history revealed preceding nephroureterectomy of the left kidney due to loss of kidney function and recurrent ureteral-vaginal fistulas. After CT scan-guided puncture and negative bacterial culture, actinomycosis could only be diagnosed by histopathological examination. Subsequently, besides abscess drainage calculated antibiotic therapeutic regimen was initiated. During the follow-up of 9 months there was no local or systemic recurrence. In the present case report, aetiology, clinical symptoms as well as diagnostic and therapeutic consequences are discussed.
An inflammation of the corpus cavernosum is relatively rare and must be differentiated from a tumour, abscess, thrombosis or embolism of the penile vessels. Most frequently inflammation of the corpus cavernosum is caused by iatrogenic interventions, followed by general infections and acute occlusion of penile vessels. Diabetes mellitus seems to be a predisposing factor. In the case of a 51-year-old diabetic patient with painful induration of the penis, an MR imaging study was undertaken to identify an inflammation of the corpora by exclusion of abscess formation. The inflammation responded well to a two-week oral Fluorchinolon treatment. Due to its high soft-tissue contrast, multiplanar layer images and, the MR scan was performed to identify an inflammation of the corpora cavernosa and to exclude an abscess formation. We consider a therapy with oral antibiotics to be sufficient for a non-abscess-forming cavernitis.
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