Clinical features of abdominopelvic actinomycosis: report of twenty cases and literature review

Yonsei Med J. 2009 Aug 31;50(4):555-9. doi: 10.3349/ymj.2009.50.4.555. Epub 2009 Aug 19.

Abstract

Purpose: Intrabdominal actinomycosis is difficult to diagnose preoperatively. This chronic infection has a propensity to mimic many other diseases and may present with a wide variety of symptoms. The aim of this study was to evaluate the characteristic clinical features with review of the literature.

Materials and methods: We retrospectively analyzed 22 patients with intrabdominal actinomycosis between January 2000 and January 2006.

Results: There were two men and 20 women with a mean age of 42.8 years (range, 24-69). Twelve patients presented with masses or abdominal pain, whereas 3 patients presented with acute appendicitis. The rate of performing an emergency surgery was 50% due to symptoms of peritonitis. The mean size of tumor was 5.5 cm (range, 2.5-11.0). Sixty percent (n = 12) of female patients had intrauterine device (IUD). The average time to definite diagnosis was 10.6 days.

Conclusion: Intrabdominal abdominal actinomycosis must first be suspected in any women with a history of current or recent IUD use who presents abdominal pain. If recognized preoperatively, a limited surgical procedure, may spare the patient from an extensive operation.

Keywords: Actinomycosis; intrauterine device; surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Pain / etiology*
  • Abdominal Pain / microbiology
  • Actinomycosis / diagnosis*
  • Actinomycosis / pathology
  • Adult
  • Aged
  • Female
  • Humans
  • Intrauterine Devices
  • Male
  • Middle Aged
  • Peritonitis / pathology
  • Peritonitis / surgery
  • Young Adult