Endoscopy 2003; 35(5): 451-453
DOI: 10.1055/s-2003-38782
Case Report
© Georg Thieme Verlag Stuttgart · New York

Abdominal Actinomycosis Presenting as Lower Gastrointestinal Bleeding

U.  Kodali 1 , R.  Mallavarapu 2 , M.  J.  Goldberg 3
  • 1 Division of Gastroenterology, Wayne State University, Detroit MI, USA
  • 2 Rush-Presbyterian-St.Luke’s Medical Center, Rush University, Chicago IL, USA
  • 3 Division of Gastroenterology, Evanston Northwestern Healthcare, Evanston IL, USA
Further Information

Publication History

Submitted 26 July 2001

Accepted after Revision 15 October 2002

Publication Date:
17 April 2003 (online)

Introduction

Abdominal actinomycosis is often difficult to diagnose because of the low index of suspicion, unusual clinical manifestations, and difficulty in culturing Actinomyces. We describe a patient with anemia, multiple ulcers in the ileocecal area, and massive gastrointestinal bleeding, who required surgical resection of the colon. The diagnosis was made on histopathological examination of the resected specimen. This is the first reported case of actinomycotic ileocecal ulceration leading to gastrointestinal bleeding. Though abdominal actinomycotic infection is rare, the chances of cure are excellent after the diagnosis has been made.

References

  • 1 Citron J R, Del Pino A, Duarte B, Wood D. Abdominal actinomycosis.  Dis Colon Rectum. 1996;  39 105-108
  • 2 Petrone L R, Sivalingam J J, Vaccaro A R. Actinomycosis - an unusual presentation of an uncommon disease.  J Am Board Fam Pract. 1999;  12 158-161
  • 3 Alvardo-Cerna R, Bracho-Riquelme R. Perianal actinomycosis - a complication of a fistula in ano: report of a case.  Dis Colon Rectum. 1994;  37 378-380
  • 4 Weese W C, Smith I M. A study of 57 cases of actinomycosis over a 36-year period.  Arch Intern Med. 1975;  135 1562-1568
  • 5 Fowler R C, Simpkins K C. Abdominal actinomycosis: a report of three cases.  Clin Radiol. 1983;  34 301-307
  • 6 Piper M H, Schaberg D R, Ross J M. et al . Endoscopic detection and therapy of colonic actinomycosis.  Am J Gastroenterol. 1992;  87 1040-1042
  • 7 Smego R A, Foglia G. Actinomycosis.  Clin Inf Dis. 1998;  26 1255-1263
  • 8 Harris L A, DeCosse J J, Dannenberg A. Abdominal actinomycosis: evaluation by computed tomography.  Am J Gastroenterol. 1989;  84 198-200
  • 9 Ha H K, Lee H J, Kim H. et al . Abdominal actinomycosis: CT findings in 10 patients.  Am J Roentgenol. 1993;  161 791-794

U. Kodali, M.D.

27573 Gateway Dr. North, #H303

Farmington Hills · MI 48334 · USA ·

Fax: + 1-313-745-8843

Email: udayini@yahoo.com

    >