Case report

Isolated hepatic actinomycosis: a case report

Thomas Lall¹ , Thomas M Shehab^1,2 and Paul Valenstein³

¹  Department of Internal Medicine, Saint Joseph Mercy Hospital, 5301 McAuley Drive, Ypsilanti, Michigan, MI 48197, USA

²  Huron Gastroenterology, 5300 Elliott Drive, Ypsilanti, MI 48197, USA

³  Department of Pathology, Saint Joseph Mercy Hospital, 5301 McAuley Drive, Ypsilanti, Michigan, MI 48197, USA

author email corresponding author email

Journal of Medical Case Reports 2010, 4:45doi:10.1186/1752-1947-4-45

Published:	8 February 2010

Abstract

Introduction

Actinomyces are slow growing, non-spore forming, gram-positive, branching bacilli that thrive in anaerobic and microareophilic conditions. Actinomyces are more commonly associated with oral and cervicofacial infections. Hepatic involvement in infections of the abdomen (known as isolated hepatic actinomycosis) is rare, accounting for only 5% of all cases of actinomycosis.

Case presentation

We present the case of a 75-year-old Caucasian woman with a 3-month history of night sweats, fever, chills, abdominal bloating, anorexia, weight-loss, and early satiety. The patient was found to have isolated hepatic actinomycosis infection after undergoing a laparotomy with a biopsy of the liver. The patient has now recovered.

Conclusion

Isolated hepatic actinomycosis is a rare and often overlooked etiology for a liver mass. Given its subacute presentation and nondescript symptomatology, physicians should be aware of this differential and the potential pitfalls in diagnosis and management.