Isolated hepatic actinomycosis: a case report
Isolated hepatic actinomycosis: a case report
Journal of Medical Case Reports 2010, 4:45
Published: February 2010
Published: February 2010
Abstract
Introduction
Actinomyces are slow growing, non-spore forming, gram-positive, branching bacilli that thrive in anaerobic and microareophilic conditions. Actinomyces are more commonly associated with oral and cervicofacial infections. Hepatic involvement in infections of the abdomen (known as isolated hepatic actinomycosis) is rare, accounting for only 5% of all cases of actinomycosis.
Case presentation
We present the case of a 75-year-old Caucasian woman with a 3- month history of night sweats, fever, chills, abdominal bloating, anorexia, weight-loss, and early satiety. The patient was found to have isolated hepatic actinomycosis infection after undergoing a laparotomy with a biopsy of the liver. The patient has now recovered.
Conclusion
Isolated hepatic actinomycosis is a rare and often overlooked etiology for a liver mass. Given its subacute presentation and nondescript symptomatology, physicians should be aware of this differential and the potential pitfalls in diagnosis and management.
Introduction
Actinomyces are slow growing, non-spore forming, gram-positive, branching bacilli that thrive in anaerobic and microareophilic onditions. It is most commonly associated with infection of the oral and cervicofacial region. Abdominal actinomycosis is rare and its pathogenesis is presumed to be hematogenous spread through the portal vein from a mucosal injury or other abdominal focus of infection. Most frequently affected is the ileocecal region. Hepatic involvement has been reported in 15% of those with abdominal infections, and represents 5% of all cases of actinomycosis [1]. iagnosis is often difficult because the predominant presenting symptoms of fever, abdominal pain, and weight loss are non-specific. Imaging is many times suspicious for neoplasm and positive cultures are notoriously difficult to obtain, making the preoperative rate of diagnosis less than 10%.
Keywords:
Isolated hepatic actinomycosis, Actinomyces, fever abdominal pain, liver abscess, right upper quadrant tenderness, exploratory laparotomy, actinomyces infection, pyogenic liver abscess,
Isolated hepatic actinomycosis, Actinomyces, fever abdominal pain, liver abscess, right upper quadrant tenderness, exploratory laparotomy, actinomyces infection, pyogenic liver abscess,
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