Abdominal actinomycosis

Abstract

The computed tomographic scan is the most helpful diagnostic modality. Appearance of abdominal actinomycosis is usually a contrast enhancing multicystic lesion as was found in these two patients. Needle aspiration cytology can be fairly accurate in obtaining the diagnosis and is recommended for suspicious lesions.

Abdominal Actinomycosis—an Interesting Case

“…The lack of a nuclear membrane, absence of chitin from cell walls, reproduction by fission and, most importantly, inhibition of growth by penicillin and insensitivity to amphotericin B classify these as bacteria and not fungi [5]. These organisms produce a characteristic granulomatous inflammatory response, with pus production and abscess formation, followed by necrosis and reactive fibrosis.…”

“…A firm mass with presence of small and multiple suppurative areas with sinus tracts is highly suspicious of abdominal actinomycosis. The well-recognized sulphur granules obtained from the pus, which can often be seen with naked eye, are found in only 50% of cases and are not pathognomonic because other organisms such as Nocardia and Streptomyces may aggregate and resemble the sulphur granules found in actinomycetes infections [5]. The cure rate has increased from 5 to 90% with the use of penicillin.…”

Actinomicose intestinal: relato de caso

“…Os actinomicetos, em especial o Actinomyces israelli, são bactérias anaeróbias ou facultativas, Gram-positivas, não ácido-resistentes e difíceis de serem cultivadas [6][7][8] . Se a resposta supurativa não erradica a bactéria, ocorre uma reação inflamatória granulomatosa característica seguida de intensa fibrose e necrose, com disseminação por contiguidade e sem respeitar os limites do órgão lesado, produzindo trajetos fistulosos [8][9][10] . Apresenta-se principalmente em três formas: cervicofacial (50%), abdominal (20%) e torácica (20%) 6,7,11 .…”

“…O diagnóstico pré-operatório é muito difícil, em torna de 10% dos casos; além disso, exames de imagem não são muito úteis para corroborar esta hipótese diagnóstica. A obstrução intestinal por actinomicose é muito rara, havendo poucos casos relatados na literatura científica 6,10 . Esta apresentação é uma indicação de tratamento cirúrgico, além dos casos em que não se consegue descartar doença neoplásica 6,7,11 .…”

Actinomycosis simulating malignant large bowel obstruction

“…This bacterium is universally distributed and is not very virulent; it is rarely related to abdominal disease. Primary bowel involvement is rare, but it has increased in frequency over the last few years [2][3][4][5][6][7][8].…”