Actinomycosis resembling liver tumor with multiple metastasis
Journal
International Journal of Infectious Diseases
Journal Volume
45
Pages
98-99
Date Issued
2016
Author(s)
Abstract
A 56-year-old woman, without any underlying diseases, was admitted due to progressive general weakness and poor appetite for 2 months followed by fever for 3 days. Abdominal computed tomography revealed a sigmoid colon tumor with liver and lymph node metastasis, bilateral obstructive hydronephrosis, and liver tumor rupture (Figure 1A , B). The patient underwent a laparoscopic partial hepatectomy and excisional biopsy of the pelvic tumor. Results from the frozen pathological analyses disclosed sulfur granule material, thus an actinomycosis infection was highly suspected. Pathology demonstrated focal aggregates of a filamentous microorganism on hematoxylin and eosin (H&E) staining (Figure 1C) and periodic acid Schiff (PAS) staining (Figure 1D), compatible with actinomycosis. Actinomycetes – filamentous, Gram-positive, anaerobic bacteria – are prominent among the normal flora of the oral cavity. They are characterized by contiguous hematogenous dissemination, suppurative and granulomatous inflammation, and multiple abscesses that may discharge sulfur granules.1Hall V. Actinomyces—gathering evidence of human colonization and infection.Anaerobe. 2008; 14: 1-7Crossref PubMed Scopus (71) Google Scholar High-dose penicillin over a long period of time (usually 6 months to 1 year) is the main treatment.2Sudhakar S.S. Ross J.J. Short-term treatment of actinomycosis: two cases and a review.Clin Infect Dis. 2004; 38: 444-447Crossref PubMed Scopus (124) Google Scholar This patient, without known risk factors for actinomycosis infection, underwent intra-abdominal drainage and was transferred to the intensive care unit for a short period of time. She was discharged after an uneventful stay on the ward. At this time, she has been receiving antibiotic treatment for over 5 months and continues to receive treatment. The fever was found to have resolved at regular follow-up. Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Conflict of interest: The authors have no conflicts of interest to declare.
SDGs
Type
note