Hepatic Actinomycosis Presenting as a Liver Tumour: Case Report and Literature Review

Abstract

Hepatic actinomycosis poses a difficult problem in both diagnosis and management. We report the management of a patient with isolated hepatic actinomycosis, and review the clinical features and management of patients with hepatic actinomycosis mimicking liver tumour.

Pulmonary actinomycosis in two chamois (Rupicapra rupicapra)

“…The typical histological lesions and the specific staining properties of lesion-associated sulphur granules make histology the most powerful and rapid diagnostic tool for pulmonary actinomycosis. Actinomycotic sulphur granules are peculiarly characterized by numerous bacterial filaments, surrounded by a striking Splendore-Hoeppli reaction that result specifically positive to gram and PAS staining, but negative to Fite's staining method for acid fast bacteria (Hotchi and Schwarz 1972;Murakami et al 1997;di Tommaso et al 1998;Ramos-Vara et al 1998;Lai et al 2004). These staining properties represent the fundamental criteria for the differential diagnosis of actinomycosis from nocardiosis and botryomycosis in which bacterial clusters may simulate actinomycosis through the formation of analogous sulphur granules within the pyogranulomatous lesions.…”

Successful switch to oral therapy with doxycycline in the case of an actinomycotic hepatic abscess

“…In a review of liver actinomycosis case reports, the most common symptoms were non-specific, including fever (83.3%), abdominal pain (74.5%), and weight loss (50.9%) [5]. Because imaging studies frequently reveal single or multiple lesions, actinomycosis is often misdiagnosed as a primary or metastatic tumor.…”

“…Treatment of hepatic actinomycosis consists of prolonged antibiotics after surgical debridement and drainage [5]. Penicillin G is the most frequently used antimicrobial to treat actinomycosis, but we chose ampicillin injection as an initial treatment due to a penicillin G shortage.…”

Hepatic Actinomycosis: A Case Report.

“…The medical treatment regimen is the administration of penicillin, tetracycline, or clindamycin [4]. Duration of treatment is variable with courses lasting from 3-6 months and it go until 18 months [7]. Surgery should be reserved for the cases in which percutaneous drainage is not possible [7].…”

“…Duration of treatment is variable with courses lasting from 3-6 months and it go until 18 months [7]. Surgery should be reserved for the cases in which percutaneous drainage is not possible [7]. A review of the literature by Wong et al showed that in one series, 28 of 53 cases were managed with antibiotics alone and only two of these required surgical intervention.…”