■放线菌病,由放线菌属引起的罕见感染。,通常表现为影响各个地区的慢性病,尤其是颈面部,胸廓,和腹部区域。由于症状与恶性肿瘤和其他感染重叠,其诊断通常很困难。本报告详细介绍了一例模仿腹部多发肿瘤的腹部放线菌病,复杂的诊断和治疗。
方法:一名67岁男性,患有未控制的2型糖尿病,表现为全身腹痛,恶心,呕吐,便秘,和显著的体重减轻。体格检查显示腹胀和严重的腹部压痛。实验室检查显示白细胞增多和贫血。诊断性剖腹手术显示腹部多发肿瘤。组织病理学证实放线菌病无恶性肿瘤或结核。开始静脉注射阿莫西林;然而,由于与他的治疗计划无关的个人原因,病人在两天后不顾医生的建议出院。三个月后,他因持续性腹痛和其他肝脏病变而返回。延长12个月的抗生素治疗可在随访期间缓解症状。
■腹部放线菌病很少见,通常与糖尿病等疾病有关。该病例强调了感染可能模拟恶性肿瘤,并强调了在急性腹部的鉴别诊断中需要考虑放线菌病。尤其是免疫功能低下的患者。患者不受控制的糖尿病可能导致感染的发展和传播。
结论:腹部放线菌病可以急性出现,模仿有多个腹腔内肿块的肿瘤性疾病。早期识别和延长抗生素治疗对于防止全身传播至关重要。尤其是在免疫受损的个体中。临床医生应考虑糖尿病和腹部症状控制不佳的患者放线菌病。
UNASSIGNED: Actinomycosis, a rare infection caused by Actinomyces spp., typically presents as a chronic condition affecting various regions, particularly the cervicofacial, thoracic, and abdominal areas. Its diagnosis is often difficult due to symptom overlap with malignancies and other infections. This report details a case of abdominal actinomycosis mimicking multiple intra-abdominal tumors, complicating diagnosis and treatment.
METHODS: A 67-year-old male with uncontrolled type 2 diabetes presented with generalized abdominal pain, nausea, vomiting, constipation, and significant weight loss. Physical examination revealed distention and severe abdominal tenderness. Laboratory tests showed leukocytosis and anemia. Diagnostic laparotomy revealed multiple intra-abdominal tumors. Histopathology confirmed actinomycosis without malignancy or tuberculosis. Intravenous amoxicillin was started; however, the patient discharged himself against medical advice after two days due to personal reasons unrelated to his treatment plan. He returned three months later with persistent abdominal pain and additional hepatic lesions. Extended antibiotic therapy for 12 months led to the resolution of symptoms during follow-up.
UNASSIGNED: Abdominal actinomycosis is rare and often associated with conditions like diabetes. This case underscores the infection\'s potential to mimic malignancy and highlights the need for considering actinomycosis in differential diagnoses of acute abdomen, especially in immunocompromised patients. The patient\'s uncontrolled diabetes likely contributed to the infection\'s development and spread.
CONCLUSIONS: Abdominal actinomycosis can present acutely, mimicking neoplastic diseases with multiple intra-abdominal masses. Early recognition and prolonged antibiotic therapy are essential to prevent systemic spread, especially in immunocompromised individuals. Clinicians should consider actinomycosis in patients with poorly controlled diabetes and abdominal symptoms.