Ferreira Cardoso Mariana, Carneiro Carla, Carvalho Lourenço Luís, Graça Rodrigues Catarina, Folgado Alberto Sara, Alagoa João Ana, Rocha Ricardo, Geraldes Vasco, Costa Ana, Reis Jorge, Nunes Vítor
Department of Gastroenterology, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
Department of General Surgery, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
ACG Case Rep J. 2017 Jun 21;4:e82. doi: 10.14309/crj.2017.82. eCollection 2017.
Actinomycosis is a rare but easily curable infection that should be considered in the differential diagnosis of perianal fistulizing disease. We present the case of a 26-year-old woman with complex perianal fistulae, including trans-sphincteric and suprasphincteric fistulous tracts and a rectovaginal fistula, requiring multiple abscess drainages, seton placement, and antibiotic courses, with little improvement. After extensive investigation, . was identified in anal cytology. The patient underwent a 6-week course of intravenous penicillin followed by oral amoxicillin, with remarkable improvement. This case illustrates the importance of pursuing less common diagnoses in refractory complex perianal disease, such as actinomycosis.
放线菌病是一种罕见但易于治愈的感染，在肛周瘘管性疾病的鉴别诊断中应予以考虑。我们报告一例26岁女性，患有复杂的肛周瘘管，包括经括约肌和括约肌上瘘管以及直肠阴道瘘，需要多次脓肿引流、放置挂线和使用抗生素疗程，但改善甚微。经过广泛检查，在肛门细胞学检查中发现了……。患者接受了为期6周的静脉注射青霉素治疗，随后口服阿莫西林，病情显著改善。该病例说明了在难治性复杂肛周疾病中寻求罕见诊断（如放线菌病）的重要性。
