Second Department of Medicine, Medical School, University of Athens, Hippokration General Hospital, Athens, Greece.
Am J Med Sci. 2010 Apr;339(4):362-5. doi: 10.1097/MAJ.0b013e3181cbf47c.
The clinical and imaging findings of primary hepatic actinomycosis are nonspecific and can mimic other diseases. This condition usually needs to be distinguished from other liver-occupying lesions, including malignancy. Review of the English language literature showed 67 cases of hepatic actinomycosis in immunocompetent, predominantly male patients. Infection was usually (75%) cryptogenic. The results of radiologic imaging showed that the lesion involved the right lobe in half of the cases, mimicked a liver tumor in 45%, and was single in two thirds of the cases. Hepatic actinomycosis coexisted with infections by common bacteria in 32% of cases reported. Diagnosis was usually achieved by microscopic examination of surgical or percutaneous specimens in 84.2% and 78.6%, respectively. Antibiotic therapy alone was used for treatment in approximately one half of cases and combined antibiotic treatment with surgical or percutaneous drainage procedure in the other half. The overall mortality rate was 7.6%. In conclusion, primary hepatic actinomycosis is a rare and usually cryptogenic infection. It is more common in men and immunocompetent subjects. It is well responsive to medical or combined medical and interventional treatment.
原发性肝放线菌病的临床和影像学表现无特异性，可模仿其他疾病。这种情况通常需要与其他肝占位性病变区分开来，包括恶性肿瘤。对英文文献的回顾显示，免疫功能正常的、主要为男性的患者中有 67 例肝放线菌病。感染通常（75%）是隐源性的。影像学检查结果显示，病变累及右叶的占一半，45%模拟肝肿瘤，三分之二的病例为单发。在报告的病例中，肝放线菌病与常见细菌感染并存的占 32%。诊断通常分别通过手术或经皮标本的显微镜检查来实现（分别为 84.2%和 78.6%）。大约一半的病例仅采用抗生素治疗，另一半病例采用抗生素联合手术或经皮引流治疗。总的死亡率为 7.6%。总之，原发性肝放线菌病是一种罕见且通常为隐源性感染。它更常见于男性和免疫功能正常的人群。它对药物或联合药物和介入治疗反应良好。
