Risk factors for intra-abdominal actinomycosis:
(1) acute appendicitis, especially with rupture
(2) bowel perforation, including diverticulitis
(3) bowel surgery
(4) foreign body associated with gastrointestinal tract
(5) intra-abdominal malignancy
A long interval between the triggering event and onset of symptoms may cause the association to be missed.
Clinical features:
(1) fever, which is often low-grade
(2) weight loss
(3) abdominal pain
(4) intra-abdominal mass or abscess
(5) sinus tract to the skin surface
(6) bowel obstruction
(7) extension to involve the pelvis
Actinomycosis can mimic many other conditions and may be mistaken for malignancy, chronic appendicitis, inflammatory bowel disease, diverticular abscess, tuberculosis or a parasitic infection.
