Hajri Mohamed, Zouari Rami, Mallek Ines, Bacha Dhouha, Bayar Rached, Ben Slama Sana
Faculty of Medicine, Universite de Tunis El Manar, Tunis, Tunis, Tunisia.
Visceral surgery, University Hospital Center Mongi Slim, La Marsa, Tunis, Tunisia.
F1000Res. 2024 Aug 29;13:669. doi: 10.12688/f1000research.151907.2. eCollection 2024.
Actinomycosis is an uncommon inflammatory bacterial disease caused by Actinomyces species, especially Actinomyces Israeli. Abdominopelvic forms are relatively rare and may involve the colon as a solid mass, mimicking a malignant tumor.
A 68-year-old Tunisian man, with a history of diabetes, hypertension, penicillin allergy, and renal failure, presented to the emergency department with abdominal pain, vomiting, and bowel obstruction. CT scan showed an acute intestinal obstruction upstream with obstructive tissular mass at the sigmoid colon. Emergency surgery revealed a sigmoid mass and a pre-perforative cecum. Total colectomy was performed, with ileostomy and distal end closure. Histological examination confirmed Actinomyces infection. The patient was then placed on long-term doxycycline and Bactrim, with no recurrence over a 9-month follow-up period.
Abdominal actinomycosis, though rare, presents diagnostic challenges. It can be mistaken for malignancy, leading to unnecessary surgery in non-complicated cases, since it is effectively treated by antibiotics. In complicated cases, a combined approach involving both surgery and antibiotic therapy is necessary until the infection is completely eradicated.
放线菌病是一种由放线菌属，尤其是以色列放线菌引起的罕见炎症性细菌疾病。腹盆腔型相对少见，可能累及结肠形成实性肿块，类似恶性肿瘤。
一名68岁的突尼斯男子，有糖尿病、高血压、青霉素过敏和肾衰竭病史，因腹痛、呕吐和肠梗阻就诊于急诊科。CT扫描显示乙状结肠上段急性肠梗阻伴梗阻性组织肿块。急诊手术发现乙状结肠肿块和穿孔前盲肠。行全结肠切除术，并行回肠造口术和远端封闭术。组织学检查确诊为放线菌感染。随后患者接受长期强力霉素和复方新诺明治疗，在9个月的随访期内无复发。
腹部放线菌病虽罕见，但存在诊断挑战。它可能被误诊为恶性肿瘤，导致在非复杂病例中进行不必要的手术，因为它可通过抗生素有效治疗。在复杂病例中，在感染完全根除之前，需要手术和抗生素治疗相结合的方法。
