Renal, colonic and retroperitoneal actinomycosis--a case report.

Department of General Surgery and Urology, Causeway Hospitals Trust Coleraine, Northern Ireland, United Kingdom.
West African journal of medicine 05/2006; 24(4):343-5. DOI: 10.4314/wajm.v24i4.28230
Source: PubMed


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.

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    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


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