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Review
. 2021 May 3;15(1):224.
doi: 10.1186/s13256-021-02812-7.

Abdominal actinomycosis mimicking a transverse colon malignancy: a case report and review of the literature

Gnanaselvam Pamathy  1 , Umesh Jayarajah  2 , Dayal Sathyajith Gamlaksha  3 , Roshana Constantine  3 , Anura S K Banagala  4
Affiliations
Review

Abdominal actinomycosis mimicking a transverse colon malignancy: a case report and review of the literature

Gnanaselvam Pamathy et al. J Med Case Rep. .

Abstract

Background: Actinomycosis is a rare inflammatory bacterial disease caused by Actinomyces species which can infrequently affect the large intestine. Disseminated actinomycosis is reported as a rare complication associated with intrauterine devices. We report a case of intra-abdominal actinomycosis mimicking a transverse colon malignancy.

Case presentation: A previously healthy 40-year-old Sinhalese woman was evaluated for intermittent colicky left-sided abdominal pain for 2 months' duration. Computed tomography of the abdomen showed a circumferential thickening of the wall and narrowing of the lumen of the descending colon with evidence of extraluminal extension to the adjacent parietal peritoneum and abdominal wall suggestive of a stage IV neoplasm. An exploratory laparotomy with extended left hemicolectomy was performed. Macroscopic evaluation revealed a mass lesion with multiple abscesses attached to the transverse and descending colon. Histology was suggestive of actinomycosis with no evidence of malignancy.

Conclusions: Abdominal actinomycosis should be considered in a young patient with chronic abdominal pain. It should be understood that the presentation may be vague and highly variable. Computed tomography-guided biopsy/fine needle aspiration or laparoscopy and biopsy may be useful in arriving at a diagnosis and can prevent unnecessary surgical intervention.

Keywords: Actinomycosis; Case report; Intra-uterine device; Transverse colon.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Section of intestinal wall: Actinomyces colony (white arrows) showing basophilic radiating filaments. Hematoxylin and eosin, ×100
Fig. 2
Fig. 2
Section of intestinal wall: Actinomyces colony (white arrow) surrounded by neutrophil-predominant inflammatory cells (yellow arrow). Hematoxylin and eosin, ×200
See this image and copyright information in PMC

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