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