Pediatr Infect Vaccine.  2018 Dec;25(3):170-175. 10.14776/piv.2018.25.e14.

Abdominal Actinomycosis Mimicking Acute Appendicitis in Children: a Case Report

• Choi SK
• Bang YG
• Oh H
• Lee J

• KMID: 2428255
• DOI: http://doi.org/10.14776/piv.2018.25.e14

Abstract

Actinomyces are anaerobic, Gram-positive bacteria that are part of the endogenous flora of mucous membranes in humans. Infection caused by these bacteria is termed actinomycosis. The 3 most common types of actinomycosis are cervicofacial, abdominopelvic, and pulmonary. A previously healthy 6-year-old boy presented with the emergency room with fever, vomiting, and abdominal pain and initially diagnosed with acute appendicitis. Exploratory laparoscopy was done. Histologic finding demonstrated acute gangrenous appendicitis complicated by perforation and sulfur granules compatible with actinomycosis. Subsequently, he was diagnosed with abdominal actinomycosis and received long-term antibiotic therapy. Abdominal actinomycosis is uncommon in children and difficult to diagnose because of its nonspecific symptoms and of difficulties in growing Actinomyces in the clinical setting. It is necessary to include abdominal actinomycosis as a differential diagnosis of children presenting with abdominal pain.

Keyword

Child; Actinomycosis; Abdomen

MeSH Terms

Abdomen
Abdominal Pain
Actinomyces
Actinomycosis*
Appendicitis*
Bacteria
Child*
Diagnosis, Differential
Emergency Service, Hospital
Fever
Gram-Positive Bacteria
Humans
Laparoscopy
Male
Mucous Membrane
Sulfur
Vomiting
Sulfur

Figure

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  Fig. 1 (A) Acute gangrenous appendicitis with actinomycotic colonies characterized by sulfur granules (H&E stain, ×40). (B) Sulfur granules with black bacterial filaments (GMS stain, ×400). Abbreviations: H&E, hematoxylin and eosin; GMS, gomori methenamine-silver stain.

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