Abstract:
Actinomycosis is a chronic suppurative infection caused by gram-positive bacteria, Actinomyces, which commonly colonize the oral cavity, urogenital tract and gastrointestinal tract. It causes opportunistic infection where the mucosal barrier is compromised and is often misdiagnosed as malignancy. We report a case of a 58-year-old female with severe abdominal pain and a palpable tender mass in the left lower quadrant. Computed tomography scan with contrast showed thickening of the transverse, descending to sigmoid colon wall and intense contrast enhancement resembling colitis with mesenteritis. At laparotomy, we found an adherent mass involving sigmoid colon with adjacent small bowel and peritoneum. We decided to perform adhesiolysis and Hartmann procedure. The culture result was negative, whereas the biopsy of sigmoid colon revealed characteristic sulfur granules of actinomycosis colony. Intravenous antibiotic combination of ceftazidime and metronidazole was administered for 14 days followed by complete resolution of symptoms. Histopathological and bacteriological examinations are keys to diagnose actinomycosis. Patients require long-term antibiotic therapy, but surgery is often required because preoperative diagnosis is difficult.
UNASSIGNED: We presented the rare case of intra-abdominal actinomycosis in IndonesiaThe case was challenging to diagnose pre-operatively based on physical examination andExploratory laparotomy revealed pseudotumor mimicking advanced stage of colon neoplasm.
摘要:
放线菌病是由革兰氏阳性菌引起的慢性化脓性感染,放线菌,通常定殖在口腔中,泌尿生殖道和胃肠道。它会导致粘膜屏障受损的机会性感染,并经常被误诊为恶性肿瘤。我们报告了一例58岁的女性,患有严重的腹痛,左下象限有明显的触痛。计算机断层扫描与对比显示增厚的横向,下降到乙状结肠壁和强烈的对比增强,类似于结肠炎伴肠系膜炎。在剖腹手术中,我们发现了一个粘连性肿块,累及乙状结肠与邻近的小肠和腹膜。我们决定进行粘连松解术和哈特曼手术。文化结果是否定的,而乙状结肠活检显示放线菌菌落的特征性硫颗粒。给予头孢他啶和甲硝唑的静脉抗生素组合14天,然后完全缓解症状。组织病理学和细菌学检查是诊断放线菌病的关键。患者需要长期抗生素治疗,但由于术前诊断困难,通常需要手术。
■我们介绍了印度尼西亚罕见的腹内放线菌病病例。该病例根据体格检查在术前诊断具有挑战性,剖腹探查术显示假瘤或模仿晚期结肠肿瘤。