J Korean Med Sci.  2011 Jul;26(7):932-937. 10.3346/jkms.2011.26.7.932.

Clinical Features of Abdominal Actinomycosis: A 15-year Experience of A Single Institute

• Sung HY
• Lee IS
• Kim SI
• Jung SE
• Kim SW
• Kim SY
• Chung MK
• Kim WC
• Oh ST
• Kang WK

• KMID: 1094266
• DOI: http://doi.org/10.3346/jkms.2011.26.7.932

Abstract

This study was designed to evaluate the clinical features of abdominal actinomycosis and to assess its therapeutic outcome. We reviewed patients with abdominal actinomycosis in Seoul St. Mary hospital, between January 1994 and January 2010. Twenty-three patients (5 male and 18 female, mean age, 47.8 yr; range, 6-75 yr), with abdominal actinomycosis were included. Emergency surgery was performed in 50% due to symptoms of peritonitis. The common presentation on preoperative computerized tomography was a mass with abscess, mimicking malignancy. The mean tumor size was 7.0 cm (range, 2.5-10.5). In all patients, actinomycotic masses were surgically removed. Mean duration of hospital stay was 17.8 days (range, 5-49). Long term oral antibiotic treatment (mean 4.2 months; range, 0.5-7.0 months) were administered to all patients. All patients were free of recurrence after a median follow up of 30.0 months (mean 35.5 +/- 14.8 months, range, 10.0-70.0 months); recurrence was not seen in any patient. In conclusion, abdominal actinomycosis should be included as a differential diagnosis when an unusual abdominal mass or abscess presents on abdominal CT. Assertive removal of necrotic tissue with surgical drainage and long term antibiotic treatment provide a good prognosis in patients with actinomycosis.

Keyword

Abdominal Actinomycosis; Unusual Abdominal Mass

MeSH Terms

*Abdomen
Actinomycosis/*diagnosis/drug therapy/surgery
Adult
Aged
Anti-Bacterial Agents/therapeutic use
Child
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Peritonitis/diagnosis/pathology/surgery
Retrospective Studies
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Fifty eight years old female presented with lower left quadrant pain for 15 days. (A) Ovoid mass of sigmoid colon mimics a malignant tumor on computerized tomography. (B) 10.0 × 8.0 cm ovoid mass on the sigmoid colon and diverticulitis with severe inflammatory adhesion to descending colon and mesentery. (C) The cut surface demonstrates typical abscess with yellowish-brown color. (D) A magnified view of the characteristic sulfur granule in the middle of purulent exudates (H&E, × 200).

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