[Present trends in abdominal actinomycosis].
BACKGROUND
Actinomycosis is a chronic infectious disease caused by bacteria in the Actinomyces genus. The pathologic, clinic and imagistic polymorphism and the rare incidence of this disease make it so frequent misdiagnosed.


METHODS
Single unit retrospective nonrandomized clinical study on over 40 years of experience in diagnosing and treating abdominal actinomycosis.


RESULTS
First case of abdominal actinomycosis was diagnosed in our clinic in 1968. During the next 36 years, between 1968 and 2004, there were registered only 3 cases, all ileo-cecal actinomycosis. In the next 3 years interval, 5 more cases were diagnosed: 4 associated with intrauterine devices (IUDs) and 1 associated with intraperitoneal remnant calculi after laparoscopic cholecystectomy. We present these last 5 cases, the first 3 having been reported elsewhere.


CONCLUSIONS
Abdominal actinomycosis is a rare disease, with variable and deceiving clinical and imagistic characters. In Romania we witness a shift in the epidemiology of this disease as a result of the introducing of the IUDs for the first time after 1990. Confronted with a female patient carrying an IUD that has an inflammatory and a pelvic tumoral syndrome of variable intensity, one should consider also the diagnosis of abdominal actinomycosis. Preoperative establishing of this diagnosis may allow, by a long antibiotic therapy, the elimination of the need for surgery or at least the decrease of its limits. A very rare cause of intraperitoneal actinomycosis is intraperitoneal gallstones remnant after laparoscopic cholecystectomy. To our knowledge, our case is the first reported in the medical literature.
Andronic
D
D
Clinica I Chirurgie, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi. candroni@gmail.com
Lupaşcu
C
C
Târcoveanu
E
E
Georgescu
St
S
Neacşu
C
C
Ferariu
D
D
Crumpei
F
F
D018784:Abdominal Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery / Q000628:therapy*; D000196:Actinomycosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007434:Intrauterine Devices / Q000009:adverse effects; D008875:Middle Aged; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology
D000900:Anti-Bacterial Agents