Sibomana Isaie, Ishimwe Michel, Maniriho Belancille, Nyampinga Carine, Ruhangaza Deogratias, Gahemba Innocent
Department of Surgery, Kibuye Referral Hospital, Rwanda.
Department of Surgery, Kibuye Referral Hospital, Rwanda.
Int J Surg Case Rep. 2021 Mar;80:105679. doi: 10.1016/j.ijscr.2021.105679. Epub 2021 Feb 21.
Abdominal actinomycetoma is a rare and often a missed diagnosis by most of clinicians due to its rarity and different clinical presentations. It is caused by Actinomyces speces which are gram positive bacilli and normal commensal inhabitants of the human bronchial and gastrointestinal tracts. A.Israelli is responsible for disease in humans once the mucosal barrier is broken.
This case report presents an adult female patient who consulted for a localized abdominal wall mass of 3 weeks duration and the clinical exam was in favor of an abdominal wall abscess, but later found to be an actinomycotoma of the colon invading the abdominal wall and forming an abdominal wall abscess. Transverse colectomy and drainage of abscess was done and she improved well.
Actinomycosis is common in the tropical and subtropical area. However, this is the first case reported in Rwanda and prompt surgical treatment and antibiotherapy have led to a good clinical outcome.
Abdominal actinomycetoma should be considered as a differential diagnosis of any abdominal wall mass for patients with known risk factors and surgery and antibiotics are the only curative treatment.
腹部放线菌病较为罕见，由于其罕见性及不同的临床表现，大多数临床医生常常会漏诊。它由放线菌属引起，放线菌属为革兰氏阳性杆菌，是人类支气管和胃肠道的正常共生菌。一旦黏膜屏障被破坏，以色列放线菌就会引发人类疾病。
本病例报告介绍了一名成年女性患者，她因持续3周的局限性腹壁肿块前来就诊，临床检查初步诊断为腹壁脓肿，但后来发现是结肠放线菌病侵犯腹壁并形成腹壁脓肿。患者接受了横结肠切除术及脓肿引流，术后恢复良好。
放线菌病在热带和亚热带地区较为常见。然而，这是卢旺达报告的首例病例，及时的手术治疗和抗生素治疗取得了良好的临床效果。
对于有已知危险因素的患者，腹部放线菌病应被视为腹壁肿块的鉴别诊断之一，手术和抗生素是唯一的治愈性治疗方法。
