An unusual case of actinomycosis involving the kidney, retroperitoneum and colon is reported. A 41 year old patient with two weeks history of loin pain was found to have a palpable renal mass on clinical examination. Imaging revealed a solid mass arising from the left kidney, invading the retroperitoneum suggestive of an invasive hypernephroma. A nephrectomy, partial resection of psoas and colonic resection with end to end anastomosis was performed. Histopathology revealed renal actinomycosis with involvement of the adjacent colon and retroperitoneum. He recovered well after surgery and was treated with penicillin for one year. Five years have elapsed since presentation without any evidence of clinical recurrence. Abdominal actinomycosis though rare, should be borne in mind while investigating patients presenting with an abdominal mass.
[Show abstract][Hide abstract] ABSTRACT: Abdominal actinomycosis is a chronic suppurative infection caused by Actinomyces species. The ileo-cecal region is most commonly affected, while the left side of the colon is more rarely involved. The infection has a tendency to infiltrate adjacent tissues and is therefore rarely confined to a single organ. Presentation may vary from non specific symptoms and signs to an acute abdomen. A computed tomography scan is helpful in identifying the inflammatory process and the organs involved. It also allows visual guidance for percutaneous drainage of abscesses, thus aiding diagnosis. Culture is difficult because of the anaerobic character and slow growth of actinomycetes. Colonoscopy is usually normal, but may shows signs of external compression. Preoperative diagnosis is rare and is established only in less than 10% of cases. In uncomplicated disease, high dose antibiotic therapy is the mainstay of treatment. Surgery is often performed because of a difficulty in diagnosis. Surgery and antibiotics are required in the case of complicated disease. Combined medical and surgical treatment achieves a cure in about 90% of cases. The authors report a case of sigmoid actinomycosis where diagnosis was made from the histology, and a review of the literature is presented.
11/2009; 1(1):62-4. DOI:10.4240/wjgs.v1.i1.62
Note: This list is based on the publications in our database and might not be exhaustive.
Klaudyna Zwierzyńska, Piotr Chęciński, Bohdan Dąbrowski, Kazimierz Niemczyk
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.