Gao Yijun, Jhamb Shaurya, Hayler Raymond, Trickett Chloe, Kwok Allan
Department of Surgery, The Sutherland Hospital, The Kingsway, Caringbah 2229, NSW, Australia.
Department of Surgery, St George Public Hospital, Gray Street, Kogarah 2217, NSW, Australia.
J Surg Case Rep. 2024 Apr 1;2024(4):rjae195. doi: 10.1093/jscr/rjae195. eCollection 2024 Apr.
Actinomycosis remains a rare and often underdiagnosed cause of appendicitis with only 10% of cases diagnosed prior to surgery. It is an important cause to consider particularly in the setting of an indolent infection with nonspecific symptoms. We present a 22 years old male who presented with 3 weeks history of lower abdominal pain who underwent laboratory investigations and imaging studies suggestive of acute appendicitis. He underwent an emergency laparoscopic caecectomy with histopathology of the specimen suggestive of actinomycosis. He recovered well postoperatively and was discharged home with a prolonged course of oral penicillins. Preoperative diagnosis of actinomycosis is uncommon and accounts for ~10% of cases. Definitive diagnosis is usually through histopathology or tissue/fluid culture. Treatment usually involves a combination of surgical resection and antibiotic therapy with a success rate of >90%.
放线菌病仍然是阑尾炎的一种罕见且常被漏诊的病因,术前仅10%的病例能被诊断出来。它是一个需要特别考虑的重要病因,尤其是在伴有非特异性症状的慢性感染情况下。我们报告一名22岁男性,他有3周的下腹痛病史,接受了实验室检查和影像学检查,提示为急性阑尾炎。他接受了急诊腹腔镜盲肠切除术,标本的组织病理学提示为放线菌病。他术后恢复良好,出院时带了一个疗程较长的口服青霉素。放线菌病的术前诊断并不常见,约占病例的10%。确诊通常通过组织病理学或组织/液体培养。治疗通常包括手术切除和抗生素治疗相结合,成功率>90%。