Abdominal actinomycosis: report of three cases

We present three cases of abdominal actinomycosis in females, one presenting with an abdominal mass and the two others underwent emergency surgery because of acute abdomen with a diagnosis of complicated acute appendicitis. The first patient (age 36 years) presented with an abdominal mass in the left lower quadrant arising from the colon as observed by abdominal computed tomography (CT). The patient was brought to the operating room and tumoral resection was done. The second and third patients (37 years and 39 years, respectively) were brought to the emergency room because of acute abdominal pain with leucocytosis. Exploratory laparotomy was performed, finding in the second patient a bilateral ovarian abscess and uterine perforation. Hysterectomy and salpingo-oophorectomy were done. In the third patient, the findings were a sigmoid mass and a bilateral tubo-ovarian abscess and these organs were resected. Samples were sent for pathologic analysis. Microscopic analysis of the specimens sent revealed the presence of "sulfur granules," and a diagnosis of actinomycosis was made. Abdominal actinomycosis is a rare disease and preoperative diagnosis is uncommon. It is necessary to complete the full course of antibiotic therapy in order to completely eradicate the disease.