Other causes of intestinal obstruction actino-mycetoma – a case report and literature review

Abstract

Introduction Actinomycosis is a rare infectious disease that affects abdominal organs and simulates oncological disease, hardly ever presents itself as a cause of intestinal obstruction. Symptoms A 43 years old, male patient with two months of left abdominal pain associated to a growth and an 8 kg weight loss, no fever or bowel habit disruption. Interventions A colonoscopy and an abdominal scanography. Results A solid heterogeneous 7 × 3.8 cm mass localized in the splenic flexure of the colon with infiltration of its walls and its surrounding fat. Colon cancer was considered as the first diagnostic possibility. During hospitalization, the patient was taken to an emergency exploratory laparotomy, due to an acute abdominal pain with bowel obstruction symptoms. Histopathological diagnosis Actinomycetoma. Conjoint continuous monitoring with the infectious disease attending, abdominal US and observation did not show new growths. Weight gain and progressive return to daily life was obtained within 8 weeks. Conclusion In low income countries, intestinal actinomycosis should be considered in the differential diagnosis of abdominal masses and chronic inflammatory processes, patient prognosis with proper management is excellent.

Comment on “Other causes of intestinal obstruction actino-mycetoma—A case report and literature review”

“…case report on "Other causes of intestinal obstruction actinomycetoma-a case report and literature review." 1 We thank them for this valuable paper.…”

“…unfortunately, diagnosis of the actinomycosis is difficult due to its various clinical presentation, rare incidence and actinomycosis infections usually have no specific symptoms, therefore its misidentified as malignancy. [1][2][3][4] Actinomycosis is characterized by multiple abscesses, sinus formation, draining sinuses, tissue destruction and particularly presence of sulphur granules. 4,5 One of the most important things to consider in Sulphur granules, this inclusion was not specific marker as actinomycetes infection; we can have formed this granules during other members of actinomycetales infection such as nocardiosis, Streptomyces, Dermatophilus, Rhodococcus as well as fungal infection particularly in Botryomycosis.…”