Ayesha Shabih, Zaidi Syeda Mahrukh Fatima, Shahid Ruqaiya, Khan Naveed Ali, Sohail Rangwala Burhanuddin
Department of Neurosurgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, Pakistan.
Department of Histopathology, Dow University Hospital, Karachi, Pakistan.
SAGE Open Med Case Rep. 2024 Jan 4;12:2050313X231222222. doi: 10.1177/2050313X231222222. eCollection 2024.
Actinomycosis is a rare, chronic, and suppurative disease caused by species, which are filamentous, obligate, Gram-positive bacteria. This report presents a case of anterior abdominal actinomycosis in a 40-year-old female with a history of intrauterine contraceptive device placement. The patient presented with severe abdominal pain, an abdominal mass, low-grade fever, and weight loss. Imaging studies revealed thickening of the left rectus abdominis muscle and pericolic fat stranding. An exploratory laparotomy confirmed dense adhesions from the transverse colon and omentum to the abdominal wall with a purulent discharge. Resection of the affected colon segment and primary anastomosis were performed. Histopathological examination revealed characteristic colonies of within abscesses, confirming the diagnosis of actinomycosis. The patient received appropriate antibiotic therapy and showed improvement. This case highlights the rare occurrence of abdominal wall actinomycosis associated with an intrauterine contraceptive device and emphasizes the importance of considering actinomycosis in the differential diagnosis of abdominal pathologies. Thus, medical history related to intrauterine contraceptive device use should be regarded as in differentials if a patient presents vague abdominal mass and pain, and small details in history should be emphasized and looked upon so that a timely decision can be made for the betterment of the patient.
放线菌病是一种由放线菌属引起的罕见、慢性化脓性疾病,放线菌属是丝状、专性、革兰氏阳性细菌。本报告介绍了一例40岁有宫内节育器放置史的女性前腹部放线菌病病例。患者表现为严重腹痛、腹部肿块、低热和体重减轻。影像学检查显示左腹直肌增厚和结肠周围脂肪条索状改变。剖腹探查证实横结肠和大网膜与腹壁有致密粘连并有脓性分泌物。进行了受累结肠段切除和一期吻合术。组织病理学检查在脓肿内发现了特征性菌落,确诊为放线菌病。患者接受了适当的抗生素治疗并有所好转。该病例突出了与宫内节育器相关的腹壁放线菌病的罕见性,并强调了在腹部病变鉴别诊断中考虑放线菌病的重要性。因此,如果患者出现不明原因的腹部肿块和疼痛,与宫内节育器使用相关的病史应被视为鉴别诊断的因素,病史中的小细节应予以重视,以便为患者的康复及时做出决策。