Limits...
Renal hemorrhagic actinomycotic abscess in pregnancy.

Smid MC, Bhardwaj NR, Di Giovanni LM, Eggener S, Torre MD - Infect Dis Rep (2014)

Bottom Line: Actinomyces israelii is a gram-positive, filamentous anaerobic bacteria colonizing the oral and gastrointestinal tracts.We present a case of this unusual infection complicating pregnancy.Increased awareness of actinomycotic abscess in the differential diagnosis of renal mass concerning for malignancy is critical to early recognition and treatment of this rare infection and most importantly, avoidance of unnecessary surgical intervention.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of North Carolina at Chapel Hill School of Medicine , NC, USA ; Department of Obstetrics and Gynecology, Chicago Lying in Hospital, University of Chicago Medicine , IL, USA.

ABSTRACT
Actinomyces israelii is a gram-positive, filamentous anaerobic bacteria colonizing the oral and gastrointestinal tracts. Retroperitoneal actinomycotic abscess is uncommon and its rare presentation as a hemorrhagic mass may be confused with malignancy. We present a case of this unusual infection complicating pregnancy. Increased awareness of actinomycotic abscess in the differential diagnosis of renal mass concerning for malignancy is critical to early recognition and treatment of this rare infection and most importantly, avoidance of unnecessary surgical intervention.

No MeSH data available.


Related in: MedlinePlus

High power view Hematoxylin and Eosin stain of abscess: sulfur granules of actinomyces colonies with dense lymphocytic infiltrate.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3987246&req=5

fig002: High power view Hematoxylin and Eosin stain of abscess: sulfur granules of actinomyces colonies with dense lymphocytic infiltrate.

Mentions: Twelve days after delivery, the patient returned with fever, right flank pain and leukocytosis of 19.7 K/UL. She was taken to the operating room where she underwent a right renal exploration, resection of retroperitoneal mass and partial nephrectomy. The pathology report revealed xanthogranulomatous pyelonephritis with occasional clusters of actinomyces infection (Figure 2). Her operation was complicated by an unsuspected duodenal injury necessitating exploratory laparotomy and repair two days later. Pathology from resection of duodenal mass showed abscess, granulation tissue and xanthogranulomatous inflammation without evidence of actinomycotic infection. Multiple pelvic fluid collections were treated with percutaneous drains inserted by interventional radiology. She was started on piperacillin/ tazobactam then switched to amoxicillin/clavulanate for six months. Subsequent computerized tomography (CT) imaging showed complete resolution of mass.


Renal hemorrhagic actinomycotic abscess in pregnancy.

Smid MC, Bhardwaj NR, Di Giovanni LM, Eggener S, Torre MD - Infect Dis Rep (2014)

High power view Hematoxylin and Eosin stain of abscess: sulfur granules of actinomyces colonies with dense lymphocytic infiltrate.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3987246&req=5

fig002: High power view Hematoxylin and Eosin stain of abscess: sulfur granules of actinomyces colonies with dense lymphocytic infiltrate.
Mentions: Twelve days after delivery, the patient returned with fever, right flank pain and leukocytosis of 19.7 K/UL. She was taken to the operating room where she underwent a right renal exploration, resection of retroperitoneal mass and partial nephrectomy. The pathology report revealed xanthogranulomatous pyelonephritis with occasional clusters of actinomyces infection (Figure 2). Her operation was complicated by an unsuspected duodenal injury necessitating exploratory laparotomy and repair two days later. Pathology from resection of duodenal mass showed abscess, granulation tissue and xanthogranulomatous inflammation without evidence of actinomycotic infection. Multiple pelvic fluid collections were treated with percutaneous drains inserted by interventional radiology. She was started on piperacillin/ tazobactam then switched to amoxicillin/clavulanate for six months. Subsequent computerized tomography (CT) imaging showed complete resolution of mass.

Bottom Line: Actinomyces israelii is a gram-positive, filamentous anaerobic bacteria colonizing the oral and gastrointestinal tracts.We present a case of this unusual infection complicating pregnancy.Increased awareness of actinomycotic abscess in the differential diagnosis of renal mass concerning for malignancy is critical to early recognition and treatment of this rare infection and most importantly, avoidance of unnecessary surgical intervention.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of North Carolina at Chapel Hill School of Medicine , NC, USA ; Department of Obstetrics and Gynecology, Chicago Lying in Hospital, University of Chicago Medicine , IL, USA.

ABSTRACT
Actinomyces israelii is a gram-positive, filamentous anaerobic bacteria colonizing the oral and gastrointestinal tracts. Retroperitoneal actinomycotic abscess is uncommon and its rare presentation as a hemorrhagic mass may be confused with malignancy. We present a case of this unusual infection complicating pregnancy. Increased awareness of actinomycotic abscess in the differential diagnosis of renal mass concerning for malignancy is critical to early recognition and treatment of this rare infection and most importantly, avoidance of unnecessary surgical intervention.

No MeSH data available.


Related in: MedlinePlus