García García J C, Núñez Fernández M J, Cerqueiro González J M, García Martín C, Rodríguez García J C, Anibarro García L, de Lis Muñoz J M, Piñeiro Gómez-Durán L
Servicio de Medicina Interna, Hospital Montecelo, SERGAS, Pontevedra.
An Med Interna. 2001 Feb;18(2):80-3.
We report two cases of isolated abdominal wall actinomycosis and review 18 previously reported cases to further characterize the clinical findings and the therapeutic management of this syndrome. This diagnosis would be advocated in patients with a palpable abdominal mass of subacute appearance with a previous history of digestive medical illness, diabetes, abdominal surgery, or prolonged IUD use. In contrast with other actinomycosis locations, remarkable data were a more elevated mean age of patients; a female predominance; a prevalent location of mass in abdominal lower left quadrant; and a shorter duration of symptomatology before to diagnosis. The CT is the first choice for imaging study and percutaneous needle aspiration would be recommended for definite diagnosis. The long-term antibiotic therapy, with or without percutaneous drainage, is the first treatment choice because is very effective and made unnecessary a more invasive surgical management. The prognosis is excellent with adequated treatment.
我们报告了两例孤立性腹壁放线菌病病例,并回顾了先前报道的18例病例,以进一步明确该综合征的临床特征及治疗方法。对于出现亚急性可触及腹部肿块且有消化内科疾病、糖尿病、腹部手术或长期使用宫内节育器病史的患者,应考虑这一诊断。与放线菌病的其他发病部位相比,显著的特点是患者平均年龄较高、女性占优势、肿块多位于左下腹部以及诊断前症状持续时间较短。CT是影像学检查的首选,明确诊断建议采用经皮针吸活检。长期抗生素治疗,无论是否联合经皮引流,都是首选治疗方法,因为其疗效显著,无需采用更具侵入性的手术治疗。经过适当治疗,预后良好。