Ewha Med J.  2014 Dec;37(Suppl):S15-S18. 10.12771/emj.2014.37.S.S15.

Actinomycosis Presented as Acute Appendicitis

• Lim SK
• Choi HJ
• Son HM
• Choi YI
• Cho MS

• KMID: 2171305
• DOI: http://doi.org/10.12771/emj.2014.37.S.S15

Abstract

Actinomycosis causes a chronic suppurative, granulomatous disease which is characterized by extensive abscess formation, and sulfur granule formation. Actinomycosis may present different clinical forms: cervicofacial, thoracic, abdominal and cerebral actinomycosis. The diagnosis can only be made after surgery. In general, patients with abdominal actinomycosis have undergone abdominal surgery. We report four cases of primary appendiceal actinomycosis presenting as acute appendicitis without history of abdomen surgery.

Keyword

Actinomycosis; Appendicitis

MeSH Terms

Abdomen
Abscess
Actinomycosis*
Appendicitis*
Diagnosis
Humans
Sulfur
Sulfur

Figure

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  Fig. 1 Computed tomography (CT) of abdomen-pelvis. (A) It shows thickening of appendiceal wall with periappendiceal soft tissue (black arrow) and right rectus muscle infiltration (white arrow). (B, C) CT scan shows appendiceal wall thickening with enhancement (arrow). (D) It shows acute appendicitis with perforation and abscess formation (arrow).

• 

  Fig. 2 Histopathologic findings. A large actinomycotic granule was embedded in acute suppurative inflammatory exudates in the appendiceal lumen. Food material presented at the center of the granule as a nidus (H&E, ×40).

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  Fig. 3 Histopathologic fingings. Tangled and irregular aggregates of delicate filamentous gram-positive bacilli are embedded within the matrix of the granule (Gram stain, ×400).

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