Benammar S, Hélardot P G, Sapin E, Adamsbaum C, Raymond J
Service de Chirurgie, Hôpital Saint-Vincent-de-Paul, Paris, France.
Eur J Pediatr Surg. 1995 Jun;5(3):180-3. doi: 10.1055/s-2008-1066200.
The authors report two cases of actinomycosis in children: one thoracic and the other retroperitoneal. They emphasize the difficulties of diagnosis before the stage of parietal extension with cutaneous fistula and characteristic yellow granular discharge. These difficulties are due to: The rarity of visceral actinomycosis, particularly in children. The lesion has a similar appearance to that of a tumor; an extensive pre-operative work-up is mandatory (ultrasound, computed tomogram scan, repeated ultrasound-guided needle biopsy), although this work-up may not necessarily lead to the correct diagnosis. A surgical biopsy will often confirm the diagnosis, provided the diagnosis has been previously considered. The necessity of using very specific tests for correct identification of the organism. Therefore, in a case of pseudo-inflammatory pseudotumor, visceral actinomycosis must be considered in order to guide microbiological and pathological studies, although this diagnosis is rare. Once the diagnosis has been made, prolonged treatment with penicillin is effective and complete recovery is generally obtained.
一例为胸内放线菌病，另一例为腹膜后放线菌病。他们强调在出现伴有皮肤瘘管和特征性黄色颗粒状分泌物的壁层扩展阶段之前诊断的困难。这些困难归因于：内脏放线菌病罕见，尤其是在儿童中。病变外观与肿瘤相似；术前必须进行广泛的检查（超声、计算机断层扫描、重复的超声引导下针吸活检），尽管这些检查不一定能得出正确诊断。如果之前考虑过该诊断，手术活检通常能确诊。为正确鉴定该病原体，需要使用非常特异的检测方法。因此，在假性炎症性假肿瘤的病例中，尽管这种诊断罕见，但必须考虑内脏放线菌病，以指导微生物学和病理学研究。一旦做出诊断，青霉素的长期治疗是有效的，通常可实现完全康复。
