Lall Thomas, Shehab Thomas M, Valenstein Paul
Department of Internal Medicine, Saint Joseph Mercy Hospital, 5301 McAuley Drive, Ypsilanti, Michigan, MI 48197, USA.
J Med Case Rep. 2010 Feb 8;4:45. doi: 10.1186/1752-1947-4-45.
Actinomyces are slow growing, non-spore forming, gram-positive, branching bacilli that thrive in anaerobic and microareophilic conditions. Actinomyces are more commonly associated with oral and cervicofacial infections. Hepatic involvement in infections of the abdomen (known as isolated hepatic actinomycosis) is rare, accounting for only 5% of all cases of actinomycosis.
We present the case of a 75-year-old Caucasian woman with a 3-month history of night sweats, fever, chills, abdominal bloating, anorexia, weight-loss, and early satiety. The patient was found to have isolated hepatic actinomycosis infection after undergoing a laparotomy with a biopsy of the liver. The patient has now recovered.
Isolated hepatic actinomycosis is a rare and often overlooked etiology for a liver mass. Given its subacute presentation and nondescript symptomatology, physicians should be aware of this differential and the potential pitfalls in diagnosis and management.
放线菌是生长缓慢、不形成芽孢、革兰氏阳性的分支杆菌，在厌氧和微需氧条件下生长旺盛。放线菌更常与口腔和 cervicofacial 感染相关。肝脏受累于腹部感染（称为孤立性肝放线菌病）较为罕见，仅占所有放线菌病病例的 5%。
我们报告一例 75 岁的白种女性，有 3 个月盗汗、发热、寒战、腹胀、厌食、体重减轻和早饱的病史。该患者在接受剖腹手术及肝脏活检后被发现患有孤立性肝放线菌病感染。患者现已康复。
孤立性肝放线菌病是肝脏肿块的一种罕见且常被忽视的病因。鉴于其亚急性表现和不明确的症状，医生应意识到这种鉴别诊断以及诊断和管理中的潜在陷阱。
