Hepatic actinomycosis

Andersen, Åse Bengård; Ravn, Pernille; KAHN, R.; Rosted, Anne; Philipsen, E. K.

doi:10.1111/j.1699-0463.1999.tb01548.x

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…In particular, remote surgical abdominal or pelvic procedures were described in 32.3% of patients [3,. Recent abdominal or pelvic surgery (≤1 year) was reported in 25 cases including intrauterine contraceptive device (IUCD) removal (n = 12) [42][43][44][45][46][47][48][49][50][51][52][53], appendectomy (n = 3) [54][55][56], gastrectomy (n = 2) [57, present case], cholecystectomy (n = 3) [34,37,58], total pancreatectomy [59], stenting bile and pancreas (n = 2) [29,60], perforated peptic ulcer (n = 1) [61], and drainage of a rectal abscess (n = 1) [62]. Other predisposing conditions included diabetes mellitus, alcohol abuse, dental caries or abscesses, the use of IUCD, viral hepatitis, chololithiasis and cholangitis, the use of illicit drugs, and end-stage renal disease-in hemodialysis.…”

Section: Review Of the Literaturementioning

confidence: 99%

A 60-Year Literature Review on Hepatic Actinomycosis

et al. 2022

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Hepatic actinomycosis (HA) is a rare infection with indolent course, atypical clinical manifestations, nonspecific laboratory and imaging findings and challenging diagnosis. We describe a case of a 35-y-old female who developed HA 2 weeks after gastrectomy. In addition, we analyzed clinical characteristics and outcome of 157 additional cases of HA identified in a 60 years’ literature review. Patients with HA were predominantly male (57%) and more than one-half were between 40 and 70 years of age. Of interest, the infection was cryptogenic in 80.8% of cases. Risk factors for HA were identified in 63.1% of the patients. Clinical presentation included fever (57.7 %), abdominal pain (52.1%), weight loss (45.1%), anorexia (27.5%), fatigue and chills (12.7% each), and malaise (12%) over a 2.35±3.5 months period. Leucocytosis, elevated alkaline phosphatase, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were the most frequent laboratory findings. Radiologic imaging revealed that the right lobe was more frequently affected (62.5%) with a single lesion found in two-thirds of cases. Diagnosis was achieved by histopathologic examination in 70.6% of cases. Cultures yielded Actinomyces in 45 instances, with A. israelii being the most frequent species. Less than one half of the patients were treated only with antibiotics, while the others received combined medical and surgical treatment. The median duration of antibiotic therapy was 135 days (range: 7-730 days). The presence of multiple lesions or solid tumor like lesions was significantly associated with medical therapy alone. The outcome was favorable in most cases (94%). Although rarely encountered, HA should be considered in patients with a chronic or subacute inflammatory process of the liver, in order to promptly diagnose and treat.

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