title: Hepatic actinomycosis presenting as repeated cholestatic reactions.
abstract: A patient with hepatic actinomycosis caused by Actinomyces odontolyticus is presented. The clinical course was characterized by 2 yr of episodic abdominal pains and fever together with marked acute elevations of serum alkaline phosphatase. The diagnosis escaped extensive laboratory studies, 2 liver biopsies and 1 laparotomy and was finally verified at a second laparotomy by histology and a positive culture. Histopathology showed multiple small abscesses. No primary focus of infection was found. Treatment with doxycycline was successful.
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis* / Q000201:enzymology; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D002779:Cholestasis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000201:enzymology
chemical_list: D000469:Alkaline Phosphatase