[Sonographically guided fine-needle aspiration of abscesses in cases of abdominal actinomycosis]

Abstract

This report describes two cases of isolated abdominal actinomycosis. a) A 52-year-old man developed a peripancreatic abscess in the course of two years after laparoscopic cholecystectomy and repeated laparotomy because of postoperative peritonitis. b) A 19-year-old man, who had a perityphlitic abscess following appendectomy performed because of appendicitis. The definitive diagnosis of abdominal actinomycosis was confirmed by percutaneous ultrasound-guided fine-needle aspiration: In both cases culture of the aspirated material yielded Actinomyces (A.) israelii. As concomitant microflora we found Klebsiella and Actinobacter species in the first case and Haemophilus (Actinobacillus) actinomycetem comitans in the other case. "Sulfur granules" obtained from the pus showed histological aggregates of Actinomyces in both cases. After surgical treatment and antibiotic therapy, both patients recovered completely.