Actinomicosis abdominal / Abdominal actinomycosis

ABSTRACT

Actimomycosis is a non opportunistic chronic infection caused by a superior bacteria that forms grains in the pus or affected organs. 54 cases have been reported in the last 50 years in the chilean literature, 51 percent were abdominal actinomycoses, 25.5 percent pelvic and 18.5 percent puñmonary. 14 cases have been treated in the last 9 years at San Borja Arriaran. Of these 7 were abdominal (1 parietal and 6 visceral forms) and 4 involved the rectosigmoid; 2 were ileocecal and occurred after an appendicectomy. The presenting picture was of a giant abdominal mass in 2 cases (1 with a colocutaneous fistula), rectal stricture in 1 case, tubo-ovarian abscess with colonic involvement in 1 case, parietal mass in 1 case and a fistula after an appendicectomy in 2 cases. Actinomuces Israelli was found in the histopathological study in three cases and in the bacteriological study in 2. All visceral forms were treated with penicillin plus tetracycline or amoxicillin during 6 to 12 months with complete and permanent recovery. 2 patients required a colonic resection due to a iatrogenic damage and an associated diverticular disease. 3 patients required a colostomy to overcome the obstruction, all of them are asymptomatic and without colostomy 18 months to 8 years later. Due to its different presentation forms, actinomycosis has been called "the great pretender" and in several ocassions the histological or bacteriological diagnosis is not achieved