Department of Infectious Diseases, The Canberra Hospital, Australia.
Singapore Med J. 2012 Jan;53(1):e9-e11.
This case report explores an unusual presentation of a commensal organism, Actinomyces, which mimicked a presentation of ovarian cancer. A 73-year-old woman presented to a tertiary level hospital with persistent left iliac fossa abdominal pain, anorexia and fever lasting over one week, with a three-month history of bright rectal bleeding. Imaging was suggestive of malignancy. Fine needle aspiration of an enlarged lymph node was non-diagnostic. Blood cultures taken at presentation became positive after two days for Gram-positive rods, which were most likely Actinomyces. The patient was treated with penicillin 1.8 g four hourly with rapid improvement. Actinomycosis is frequently misdiagnosed as malignancy initially due to its relatively indolent course. Lesions often resolve with antibiotics, without the need for surgical intervention.
本病例报告探讨了一种共生体放线菌的不常见表现,其表现类似于卵巢癌。一名 73 岁女性因持续性左髂窝腹痛、食欲不振和发热超过一周,伴有三个月的直肠出血就诊于三级医院。影像学提示恶性肿瘤。肿大淋巴结的细针抽吸未能明确诊断。入院时采集的血培养两天后呈革兰阳性杆菌阳性,最可能是放线菌。患者接受青霉素 1.8 g 每四小时一次治疗,病情迅速改善。放线菌病由于其相对惰性的病程,最初常被误诊为恶性肿瘤。病变通常通过抗生素治疗即可消退,无需手术干预。