title: Hepatic actinomycosis: report of one case and analysis of 32 previously reported cases.
abstract: Hepatic actinomycosis is rare, with few published cases. There are no characteristic clinical manifestations, and computed tomography (CT) shows mainly low-density images, making clinical diagnosis difficult, and leading to frequent misdiagnosis as primary liver cancer, metastatic liver cancer or liver abscess. Diagnosis normally requires examination of both the aetiology and pathology. This article reports one male patient aged 55 who was hospitalized because of repeated upper abdominal pain for more than 2 mo. He exhibited no chills, fever or yellow staining of the skin and sclera, and examination revealed no positive signs. The routine blood results were: haemoglobin 110 g/L, normal numbers of leukocytes and neutral leukocytes, serum albumin 32 g/L, negative serum hepatitis B markers and hepatitis C antibodies, normal tumour markers (alpha-fetoprotein and carcinoembryonic antigen). An abdominal CT scan revealed an 11.2 cm × 5.8 cm × 7.4 cm mass with an unclear edge in the left liver lobe. The patient was diagnosed as having primary liver cancer, and left lobe resection was performed. The postoperative pathological examination found multifocal actinomycetes in the hepatic parenchyma, which was accompanied by chronic suppurative inflammation. A focal abscess had formed, and large doses of sodium penicillin were administered postoperatively as anti-infective therapy. This article also reviews 32 cases reported in the English literature, with the aim of determining the clinical features and treatment characteristics of this disease, and providing a reference for its diagnosis and treatment.
authors.affiliation: Xing-Xiang Yang, Jian-Mei Lin, Kai-Ju Xu, Shu-Qiang Wang, Ting-Ting Luo, Xiao-Xia Geng, Ren-Gang Huang, Nan Jiang, Department of Infectious Disease, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China.
authors.forename: Xing-Xiang
authors.initials: XX
authors.lastname: Yang
authors.affiliation: Xing-Xiang Yang, Jian-Mei Lin, Kai-Ju Xu, Shu-Qiang Wang, Ting-Ting Luo, Xiao-Xia Geng, Ren-Gang Huang, Nan Jiang, Department of Infectious Disease, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China.
authors.forename: Jian-Mei
authors.initials: JM
authors.lastname: Lin
authors.affiliation: Xing-Xiang Yang, Jian-Mei Lin, Kai-Ju Xu, Shu-Qiang Wang, Ting-Ting Luo, Xiao-Xia Geng, Ren-Gang Huang, Nan Jiang, Department of Infectious Disease, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China.
authors.forename: Kai-Ju
authors.initials: KJ
authors.lastname: Xu
authors.affiliation: Xing-Xiang Yang, Jian-Mei Lin, Kai-Ju Xu, Shu-Qiang Wang, Ting-Ting Luo, Xiao-Xia Geng, Ren-Gang Huang, Nan Jiang, Department of Infectious Disease, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China.
authors.forename: Shu-Qiang
authors.initials: SQ
authors.lastname: Wang
authors.affiliation: Xing-Xiang Yang, Jian-Mei Lin, Kai-Ju Xu, Shu-Qiang Wang, Ting-Ting Luo, Xiao-Xia Geng, Ren-Gang Huang, Nan Jiang, Department of Infectious Disease, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Luo
authors.affiliation: Xing-Xiang Yang, Jian-Mei Lin, Kai-Ju Xu, Shu-Qiang Wang, Ting-Ting Luo, Xiao-Xia Geng, Ren-Gang Huang, Nan Jiang, Department of Infectious Disease, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China.
authors.forename: Xiao-Xia
authors.initials: XX
authors.lastname: Geng
authors.affiliation: Xing-Xiang Yang, Jian-Mei Lin, Kai-Ju Xu, Shu-Qiang Wang, Ting-Ting Luo, Xiao-Xia Geng, Ren-Gang Huang, Nan Jiang, Department of Infectious Disease, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China.
authors.forename: Ren-Gang
authors.initials: RG
authors.lastname: Huang
authors.affiliation: Xing-Xiang Yang, Jian-Mei Lin, Kai-Ju Xu, Shu-Qiang Wang, Ting-Ting Luo, Xiao-Xia Geng, Ren-Gang Huang, Nan Jiang, Department of Infectious Disease, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000196:Actinomycosis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003951:Diagnostic Errors; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D008113:Liver Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers
keywords: Actinomycosis; Diagnosis; Liver; Therapeutics