Actinomycosis : Eight Case Reports

F Limaïem, A Khadhar, S Ben Slama, A Lahmar, S Bouraoui, S Mzabi

Abstract


to analyze clinicopathological characteristics of actinomycosis involving different organs and review the current literature.
Between August 1998 and December 2010, eight cases of actinomycosis involving different organs were diagnosed at the pathology department of Mongi Slim Hospital. Relevant clinical information and microscopic slides were available in almost all cases and were retrospectively reviewed.
Our study group included two men and 6 women (sex ratio M/F = 0.33) aged between 22 and 84 years (mean = 56.5 years) . In our series, actinomycosis involved the ovary (n=2), the gallbladder (n=1), the broad ligament (n=1), the endometrium (n=1), the rectum (n=1), the colon (n=1) and the nasopharyngeal tonsil (n=1). Histopathological examination of the surgical or biopsy specimens established the diagnosis of actinomycosis in all cases. The inflammatory reaction in actinomycosis was suppurative, with formation of abscesses that contained one or more granules (organized aggregates of filaments) that were bordered by eosinophilic club-like material.
Actinomycosis is a rare, chronic disease caused by a group of anaerobic Gram-positive bacteria that normally colonize the mouth, colon and urogenital tract. Infection involving the cervicofacial area is the most common clinical presentation, followed by pelvic region and thoracic involvement. Actinomycosis is still a disease that poses a great diagnostic challenge because of its insidious course and non-specific symptoms. Due to its propensity to mimic many other diseases and its wide variety of symptoms, clinicians should be aware of its multiple presentations and its ability to be a great pretender.

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