PubMed · 1037005
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A P Seltzer. 1976. Tonsillectomy: an excision biopsy.. https://pubmed.ncbi.nlm.nih.gov/1037005/
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A case of actinomycosis of the abdomen ten years after surgery for acute appendicitis is reported. The patient, a 2 1/2 years old girl at the time of operation, presented with acute abdominal pain ten years after appendectomy. Computed tomography (CT) showed a mass in the region of the right psoas muscle. Fine needle aspiration revealed pus which on culture was found to contain Actinomyces israeli. Since surgery is a well known probable cause of abdominal actinomycosis, we must assume the appendectomy and the formation of the actinomycotic abscess to be related. Discovery of an abdominal mass even years after violation of the gastrointestinal tract should arouse suspicion of an abscess involving these otherwise infrequent pathogens.
Medical records of 48 dogs with cutaneous actinomycosis or nocardiosis were reviewed. Male, large-breed dogs kept outdoors were overrepresented. The mean age at admission was 3.6 years. Cutaneous swelling (68%), abscesses (65%), draining tracts (48%), fever (36%), and signs of pain (13%) were the most common clinical findings. The cervicofacial area was affected in 48% of the dogs. Abdominal and thoracic wall involvement was less common. Leukocytosis, neutrophilia with left shift, monocytosis, and hyperglobulinemia were common. The diagnosis was confirmed by cytologic examination, bacteriologic culture, or histologic examination. Gram-positive filamentous bacteria were seen in 69% of the fine needle aspirates and in 50% of the biopsy specimens. Actinomyces spp were isolated from cutaneous lesions in 27 (60%) dogs. Nocardia asteroides was isolated from 1 dog. Treatment consisted of surgical debridement, drainage, and administration of antibiotics in 29 dogs (group A) and antibiotics alone in 13 dogs (group B). The infection redeveloped in 10 (42%) group-A dogs and 6 (60%) group-B dogs. Of the 10 group-A dogs with recurrent infection, 6 had resolution after a second surgery and 4 were euthanatized. Of the 6 group-B dogs, 1 had resolution after surgery, 4 were euthanatized or died because of persistent disease, and 1 had an unresolved infection. The combination of surgery and antibiotic treatment appeared to be superior to antibiotic treatment alone in resolving cutaneous Actinomyces and Nocardia infections.