[Abscess-forming retroperitoneal actinomycosis after urogynaecological surgery].
Human actinomycosis is an infrequent chronic infection caused by gram-positive anaerobic bacteria with predominantly cervicofacial and intestinal manifestation. Retroperitoneal abscess formation displays a very rare localisation and is mostly incidentally diagnosed by histological examination. We report on a 44-year-old woman with left-sided flank pain and retroperitoneal abscess formation diagnosed by CT scan. Case history revealed preceding nephroureterectomy of the left kidney due to loss of kidney function and recurrent ureteral-vaginal fistulas. After CT scan-guided puncture and negative bacterial culture, actinomycosis could only be diagnosed by histopathological examination. Subsequently, besides abscess drainage calculated antibiotic therapeutic regimen was initiated. During the follow-up of 9 months there was no local or systemic recurrence. In the present case report, aetiology, clinical symptoms as well as diagnostic and therapeutic consequences are discussed.
Rud
O
O
Urologische Klinik, St. Elisabeth-Klinikum Straubing, St.-Elisabeth-Straße 23, 94315 Straubing. oleg.rud@klinikum-straubing.de
May
M
M
Brookman-May
S
S
Mörsler
J
J
Rotter
M
M
Gilfrich
C
C
D018784:Abdominal Abscess / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000196:Actinomycosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004322:Drainage; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000175:diagnosis / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000601:surgery; D009399:Nephrons / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012008:Recurrence; D012187:Retroperitoneal Space; D014057:Tomography, X-Ray Computed; D014718:Vesico-Ureteral Reflux / Q000601:surgery
D019980:Amoxicillin-Potassium Clavulanate Combination