A rare case of subacute appendicitis, actinomycosis as the final pathology reports: A case report and literature review

International Journal of Surgery Case Reports
G A Gómez-TorresC F Ploneda-Valencia

Abstract

Acute appendicitis is the most common indication for an emergency abdominal surgery in the world, with a lifetime incidence of around 10%. Actinomycetes are the etiology of appendicitis in only 0.02%-0.06%, having as the final pathology report a chronic inflammatory response; less than 10% of the cases are diagnosed before surgery. Here, we present the case of a subacute appendicitis secondary to actinomycosis. A 39-year-old male presented with a twelve-day evolution of intermittent abdominal pain in the right lower quadrant, treated at the beginning with ciprofloxacin and urinary analgesic. The day of the admission he referred intense abdominal pain with nausea. An open appendectomy was preformed, finding a tumor-like edematous appendix with a diameter of approximately 2.5cm. Actinomyces are part of the typical flora of the oral cavity, gastrointestinal tract and vagina. The predominant form of human disease is A. Israelii, it requires an injury to the normal mucosa to penetrate and cause disease. Abdominal actinomycosis involves the appendix and caecum in 66% of the presentations, of these, perforated appendicitis is the stimulus in 75% of the cases. A combination of antibiotic therapy and operative treatment resolves actinom...Continue Reading

Citations

Feb 26, 2019·BMJ Case Reports·Malathy BalakrishnanEdmund Leung
Apr 21, 2020·Case Reports in Surgery·Michael PagaczLydia Howard
Jun 26, 2020·Journal of Pathology and Translational Medicine·You-Na Sung, Jihun Kim

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Actinomycosis

Actinomycosis is a rare, chronic, and slowly progressive granulomatous disease caused by filamentous Gram positive anaerobic bacteria from the Actinomycetaceae family (genus Actinomyces). The disease is characterised by the formation of painful abscesses in the mouth, lungs,breast or gastrointestinal tract. Discover the latest research on actinomycosis here.

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