Case report: actinomycosis of the appendix—an unusual cause of acute appendicitis in children

A rare case of subacute appendicitis, actinomycosis as the final pathology reports: A case report and literature review

“…Abdominal actinomycosis involves the appendix and caecum in 66% of the presentations [18], [19], of these, perforated appendicitis is the stimulus in 75% of the cases [19]; therefore, as in our case, the disease is rarely found in an inflamed but intact appendix [8]. Clinical presentation has an indolent course, with an initial nonspecific presentation, usually with lower abdominal pain and fever, with less than 10% of the cases diagnosed before surgery [8], [9], [10].…”

Utility of Computed Tomography in Interval Appendectomy for Actinomycotic Appendicitis

“…Only a few cases of appendicitis arising from actinomycosis have been reported [2][3][4][5][6][7]. However, performing an interval appendectomy and tracking with CT examination during the period of non-operative management is where our case differs from previously reported ones.…”

“…With an incidence rate between 1/300,000 and 1/1,000,000 [9], abdominal actinomycosis (AA) constitutes 20% of all cases of actinomycosis [2]. The appendix and ileocecal region are common sites of involvement [9] and 65% of AA cases are associated with acute appendicitis [3]. …”

“…Only a few studies have reported cases of abdominal actinomycosis detected in the appendix [2][3][4][5][6][7], and all but one patient among the previously reported cases underwent an urgent appendectomy, We initially treated the patient with non-operative management followed by interval appendectomy, although his CT scan showed findings of acute appendicitis, we determined that the patient was in the late course of the disease. Fortunately, using a CT scan before surgery, we could confirm the response to four weeks of antibiotic therapy.…”

Periappendiceal Actinomycosis Presenting as Acute Appendicitis

“…The overall incidence of actinomycosis is virtually impossible to ascertain since failure to consider it as a diagnosis and difficulty confirming it lead to under-reporting [9]. Approximately 65% of abdominal actinomycosis cases occur in association with acute appendicitis [10].…”