Al-Nasseri Abraheim, Hammad Walaa, Younes Islam, Sachdeva Nikhita, Elkattawy Sherif, Omran Ahmed, Mowafy Ahmed, Fish Heidi
Internal Medicine, St. George's University School of Medicine, Elizabeth, USA.
Pathology and Laboratory Medicine, Ain Shams University Hospital, Cairo, EGY.
Cureus. 2022 Apr 8;14(4):e23954. doi: 10.7759/cureus.23954. eCollection 2022 Apr.
Actinomycetes are commensal inhabitants of the oral cavity and gastrointestinal tract that can acquire pathogenicity through invasion of injured mucosa. Appendix and ileocecal regions are the most common sites involved in abdominal actinomycosis. We report a case of unusual site actinomycosis, in the recto-sigmoid colon, presenting with abdominal pain and diarrhea after one year of partial sigmoid colectomy. A colonoscopy was done, which showed a 21 mm polypoid partially obstructing mass in the recto-sigmoid colon. Histopathology showed granulation tissue with severe acute inflammation, fibrinopurulent debris with areas of abscess, and branching filamentous organisms with sulfur granules consistent with actinomycosis. Abdominal actinomycosis can infect almost all organs within the abdominal cavity; however, it is more common around the ileocecal region.
放线菌是口腔和胃肠道的共生菌，可通过侵入受损黏膜而获得致病性。阑尾和回盲部是腹部放线菌病最常累及的部位。我们报告一例罕见部位的放线菌病，位于直肠乙状结肠，患者在乙状结肠部分切除术后一年出现腹痛和腹泻。进行了结肠镜检查，结果显示在直肠乙状结肠有一个21毫米的息肉样部分阻塞性肿物。组织病理学显示为肉芽组织伴严重急性炎症、含有脓肿区域的纤维脓性碎屑以及与放线菌病相符的带有硫磺颗粒的分支丝状菌。腹部放线菌病可感染腹腔内几乎所有器官；然而，在回盲部周围更为常见。
