■放线菌病是一种罕见的亚急性或慢性化脓性细菌性肉芽肿性感染性疾病,具有临床异质性。大多数放线菌病是腹外起源的,口颈面部病例占55%,腹肾盂占20%,和胸部占总报告的15%。目前,腹部放线菌病发病率约为每119,000人中1例,在男性中被发现的频率是男性的三倍。我们报告了两种罕见的腹部放线菌病的临床表现,影响肠系膜和腹膜后,分别。
■一名58岁的白人男性出现在我们的诊所,右上腹腹痛。术前评估,虽然没有定论,显示肠系膜肿块浸润右侧和横结肠。患者接受剖腹探查术。部分切除肿块后,组织病理学报告显示肠系膜放线菌病。
一名40岁的白人男性出现在我们的诊所,抱怨右侧腹股沟区域的一个孔口有粘液脓性物质。经过适当的处理,一个大的腹骨盆,显示腹膜后的星状肿块(75x22.8mm)。手术与适当的抗生素一起用于治疗患者。
■术前怀疑和诊断放线菌病是非常具有挑战性的,误诊率高,往往导致延误治疗。我们的病例报告强调,腹部放线菌病应该始终是鉴别诊断的一部分,尤其是多器官受累的时候。放线菌病的金标准治疗是手术切除并延长抗生素治疗。
UNASSIGNED: Actinomycosis is an uncommon subacute or chronic suppurative bacterial granulomatous infectious disease with clinical heterogeneity. The majority of actinomycosis cases were of extra-abdominal origin, with oro-cervico-facial cases representing 55%, abdominopelvic representing 20%, and thoracic representing 15% of total reports. Currently, abdominal actinomycosis incidence is approximately 1 case per 119,000 people, being found three times more frequently among males. We report two rare clinical presentations of abdominal actinomycosis affecting the mesentery and the retroperitoneum, respectively.
UNASSIGNED: A 58-year-old Caucasian male presented to our clinic with abdominal pain in the right upper quadrant. Pre-operative evaluation, although inconclusive, showed a mesocolic mass infiltrating the right and transverse colon. The patient underwent exploratory laparotomy. After partial resection of the mass, the histopathology report demonstrated
mesenteric actinomycosis.
UNASSIGNED: A 40-year-old Caucasian male presented to our clinic complaining about a mucopurulent material from an orifice at the right inguinal region. After appropriate work-up, a large abdominopelvic, stellate mass (75 x 22.8 mm) in the retroperitoneum was revealed. Surgery along with the appropriate antibiotics was used to treat the patient.
UNASSIGNED: Preoperative suspicion and diagnosis of actinomycosis are very challenging, with a high rate of misdiagnosis often resulting in delayed treatment. Our case reports highlight that abdominal actinomycosis should always be part of differential diagnosis, especially when there is involvement of multiple organs. The gold standard treatment of actinomycosis is surgical excision with prolonged antibiotic treatment.