Postal A, Detry O, Louis E, Hardy N, Belaïche J, Jacquet N
Department of Abdominal Surgery, University Hospital of Liège, CHU Sart Tilman B35, B-4000 Liège, Belgium.
Acta Gastroenterol Belg. 2001 Oct-Dec;64(4):318-20.
Abdominal actinomycosis is a rare infectious disease caused by Actinomyces israelii, a gram-positive anaerobic saprophyte germ that is a normal inhabitant of the upper intestinal tract in humans. Actinomyces israelii rarely cause abdominal infections or actinomycosis. Abdominal actinomysosis is characterised by fistulae and abscesses and may mimic cancer or inflammatory bowel disease. Abdominal actinomycosis is difficult to diagnose preoperatively, and often require surgical removal of the diseased tissue, allowing pathologists for giving the definitive diagnosis, revealed by characteristic "sulfur granules". The authors report herein the case of a 47-year-old man who presented with diarrhoea and abdominal pain. Abdominal computed tomography evoked complicated inflammatory bowel disease and surgical procedure was decided. Laparoscopic exploration did not provide further significant information, and laparotomy with diseased bowel resection was performed. Pathology demonstrated "sulfur granules" and allowed the diagnosis of abdominal actinomycosis. This case demonstrated that abdominal actinomycosis should be included in the differential diagnosis when computed tomography shows an infiltrative and inflammatory mass.
腹部放线菌病是一种由以色列放线菌引起的罕见传染病，以色列放线菌是一种革兰氏阳性厌氧腐生菌，是人类上消化道的正常寄居菌。以色列放线菌很少引起腹部感染或放线菌病。腹部放线菌病的特征为瘘管和脓肿，可能类似癌症或炎症性肠病。腹部放线菌病术前难以诊断，通常需要手术切除病变组织，以便病理学家通过特征性的“硫磺颗粒”做出明确诊断。本文作者报告了一例47岁男性患者，该患者出现腹泻和腹痛。腹部计算机断层扫描提示复杂性炎症性肠病，遂决定进行手术。腹腔镜探查未提供更多重要信息，于是进行了开腹病变肠段切除术。病理检查发现了“硫磺颗粒”，确诊为腹部放线菌病。该病例表明，当计算机断层扫描显示浸润性炎性肿块时，腹部放线菌病应列入鉴别诊断。
