Primary hepatic actinomycosis mimicking a tumor (inflammatory pseudotumor): Case report and literature review
Abstract
Actinomycosis often manifests with abscesses in the cervicofacial region. Hepatic involvement occurs usually secondary to an intraabdominal infection. “Isolated or primary hepatic actinomycosis (PHA) defines actinomycosis in which the source of infection cannot be demonstrated elsewhere. Herein, we aimed to highlight hepatic actinomycosis in the differential diagnosis of hepatic mass lesions, and also its occurrence even in patients without underlying risk factors. A 24-year-old man, who presented with epigastric and right-upper-quadrant abdominal pain, fever, weight loss, and had a tumor-like mass in the liver was admitted to our hospital. He had no predisposing risk factors or comorbidities. We reviewed all the cases with PHA, who had no predisposing risk factors, in English medical literature from 1993 to 2014. Actinomycotic hepatic pseudotumors should be considered in the differential diagnosis of solitary liver lesions even in patients without any predisposing factors. Multi-disciplinary approach is important in the diagnosis and management. J Microbiol Infect Dis 2015;5(2): 79-84
Key words: Actinomycosis, Actinomyces spp, inflammatory pseudotumor, liver
References
- Burden P. Actinomycosis. J Infect 1989;19:95-99.
- Cope Z. Actinomycosis involving the colon and the rectum. J Int Coll Surg 1949;12:401-404.
- Weese WC, Smith IM. A study of 57 cases of actinomycosis over a 36-year period. A diagnostic ‘failure’ with good prognosis after treatment. Arch Intern Med 1975;135:1562-1568.
- Cintron JR, Del Pino A, Duarte B, Wood D. Abdominal actinomycosis.
- Dis Colon Rectum 1996;39:105-108.
- Piper MH, Schaberg DR, Ross JM, et al. Endoscopic detection and therapy of colonic actinomycosis. Am J Gastroenterol 1992;87:1040-1042.
- Kanellopoulou T, Alexopoulou A, Tanouli MI, et al. Primary hepatic
- actinomycosis. Am J Med Sci 2010;339:362-365.
- Tamsel S, Demirpolat G, Killi R, Elmas N. [Primary hepatic actinomycosis: a case of inflammatory pseudotumor (case
- report)]. Tani Girisim Radyol 2004;10:154-157.
- Wong JJ, Kinney TB, Miller FJ, Rivera-Sanfeliz G. Hepatic actinomycotic abscesses: diagnosis and management. AJR Am J Roentgenol 2006;186:174-176.
- Miyamoto MI, Fang FC. Pyogenic liver abscess involving Actinomyces: case report and review. Clin Infect Dis 1993;16:303-309.
- Lai AT, Lam CM, Ng KK, et al. Hepatic actinomycosis presenting as a liver tumour: case report and literature review. Asian J Surg 2004;27:345-347.
- Uehara Y, Takahashi T, Yagoshi M, et al. Liver abscess of Actinomyces israelii in a hemodialysis patient: case report and review of the literature. Intern Med 2010;49:2017-2020.
- Sheth S, Fishman EK, Sanders R. Actinomycosis involving the liver. Computed tomography/ultrasound correlation. J Ultrasound Med 1987;6:329-331.
- Kocabay G, Cagatay A, Eraksoy H, et al. A case of isolated hepatic actinomycosis causing right pulmonary empyema. Chin Med J (Engl) 2006;119:1133-1135.
- Putman HC, Jr., Dockerty MB, Waugh JM. Abdominal actinomycosis;
- an analysis of 122 cases. Surgery 1950;28:781-800.
- Lall T, Shehab TM, Valenstein P. Isolated hepatic actinomycosis: a case report. J Med Case Rep 2010;4:45.
- Islam T, Athar MN, Athar MK, et al. Hepatic actinomycosis with infiltration of the diaphragm and right lung: a case report. Can Respir J 2005;12:336-337.
- Deshmukh N, Heaney SJ. Actinomycosis at multiple colonic sites. Am J Gastroenterol 1986;81:1212-1214.
- Sharma M, Briski LE, Khatib R. Hepatic actinomycosis: an overview of salient features and outcome of therapy. Scand J Infect Dis 2002;34:386-391.
Abstract
Aktinomikoz genellikle servikofasiyal bölgede abseler şeklinde ortaya çıkar. Karaciğer tutulumu çoğunlukla batın içi enfeksiyonlara ikincil olarak gelişir. “İzole veya Primer Hepatik Aktinomikoz (PHA)” başka bir enfeksiyon odağının gösterilemediği karaciğer yerleşimli aktinomikozu tanımlar. Burada, hepatik aktinomikozun karaciğerde saptanan kitle lezyonlarının ayırıcı tanısında yer alması gerektiğini ve risk faktörü olmayan hastalarda da gelişebileceğini vurgulamayı amaçladık. Epigastrik hassasiyet, sağ üst kadran ağrısı, ateş, kilo kaybı yakınmalarıyla başvuran 24 yaşında erkek hasta, görüntülemede karaciğerde tümör-benzeri kitle saptanması nedeniyle hastanemize yatırıldı. Hastanın, Aktinomikoz için herhangi bir risk faktörü veya eşlik eden hastalığı yoktu. İngilizce tıp literatüründeki 1993-2014 yılları arasındaki tüm benzer PHA olgularını derledik. Aktinomikotik karaciğer psödotümörleri, hiçbir risk faktörü veya ek hastalığı olmayan hastalarda bile soliter karaciğer lezyonlarının ayırıcı tanısında hatırlanmalıdır. Tanı ve tedavide multidisipliner yaklaşım çok önemlidir
References
- Burden P. Actinomycosis. J Infect 1989;19:95-99.
- Cope Z. Actinomycosis involving the colon and the rectum. J Int Coll Surg 1949;12:401-404.
- Weese WC, Smith IM. A study of 57 cases of actinomycosis over a 36-year period. A diagnostic ‘failure’ with good prognosis after treatment. Arch Intern Med 1975;135:1562-1568.
- Cintron JR, Del Pino A, Duarte B, Wood D. Abdominal actinomycosis.
- Dis Colon Rectum 1996;39:105-108.
- Piper MH, Schaberg DR, Ross JM, et al. Endoscopic detection and therapy of colonic actinomycosis. Am J Gastroenterol 1992;87:1040-1042.
- Kanellopoulou T, Alexopoulou A, Tanouli MI, et al. Primary hepatic
- actinomycosis. Am J Med Sci 2010;339:362-365.
- Tamsel S, Demirpolat G, Killi R, Elmas N. [Primary hepatic actinomycosis: a case of inflammatory pseudotumor (case
- report)]. Tani Girisim Radyol 2004;10:154-157.
- Wong JJ, Kinney TB, Miller FJ, Rivera-Sanfeliz G. Hepatic actinomycotic abscesses: diagnosis and management. AJR Am J Roentgenol 2006;186:174-176.
- Miyamoto MI, Fang FC. Pyogenic liver abscess involving Actinomyces: case report and review. Clin Infect Dis 1993;16:303-309.
- Lai AT, Lam CM, Ng KK, et al. Hepatic actinomycosis presenting as a liver tumour: case report and literature review. Asian J Surg 2004;27:345-347.
- Uehara Y, Takahashi T, Yagoshi M, et al. Liver abscess of Actinomyces israelii in a hemodialysis patient: case report and review of the literature. Intern Med 2010;49:2017-2020.
- Sheth S, Fishman EK, Sanders R. Actinomycosis involving the liver. Computed tomography/ultrasound correlation. J Ultrasound Med 1987;6:329-331.
- Kocabay G, Cagatay A, Eraksoy H, et al. A case of isolated hepatic actinomycosis causing right pulmonary empyema. Chin Med J (Engl) 2006;119:1133-1135.
- Putman HC, Jr., Dockerty MB, Waugh JM. Abdominal actinomycosis;
- an analysis of 122 cases. Surgery 1950;28:781-800.
- Lall T, Shehab TM, Valenstein P. Isolated hepatic actinomycosis: a case report. J Med Case Rep 2010;4:45.
- Islam T, Athar MN, Athar MK, et al. Hepatic actinomycosis with infiltration of the diaphragm and right lung: a case report. Can Respir J 2005;12:336-337.
- Deshmukh N, Heaney SJ. Actinomycosis at multiple colonic sites. Am J Gastroenterol 1986;81:1212-1214.
- Sharma M, Briski LE, Khatib R. Hepatic actinomycosis: an overview of salient features and outcome of therapy. Scand J Infect Dis 2002;34:386-391.
Details
| Primary Language | English |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | July 16, 2015 |
| Published in Issue | Year 2015 Volume: 5 Issue: 2 |