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Case Reports in Infectious Diseases
Volume 2017, Article ID 1972023, 3 pages
https://doi.org/10.1155/2017/1972023
Case Report

Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

1University of Arkansas for Medical Science, 4301 West Markham Street, Little Rock, AR 72205, USA
2Chicago Medical School, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd., North Chicago, IL 60064, USA

Correspondence should be addressed to Ali Ridha; moc.oohay@ahdir.mila

Received 15 November 2016; Accepted 23 January 2017; Published 19 February 2017

Academic Editor: Gernot Walder

Copyright © 2017 Ali Ridha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms.