Extensive chronic xanthogranulomatous intra-abdominal inflammation due to Mycoplasma hominis mimicking a malignancy: a case report

INTRODUCTION: While infectious peritonitis is a common occurrence in patients with liver cirrhosis, Mycoplasma is rarely identified as a causative agent. CASE PRESENTATION: We report the case of a 43-year-old Caucasian woman presenting with an extensive abdominal conglomerate tumor mimicking malignancy. A histologic specimen showed a xanthogranulomatous inflammation. Subsequently, Mycoplasma hominis was identified as the specific causative infectious agent using a broad-range (eubacterial) polymerase chain reaction. To the best of our knowledge, this is the first reported case of an intra-abdominal Mycoplasma infection presenting as a conglomerate tumor. CONCLUSION: An unusual presentation of an inflammatory process in the abdomen or an insufficient response to conventional therapy should prompt clinicians to consider atypical infectious agents in the differential diagnosis. This case illustrates the potential of newer diagnostic methods, since certain fastidious microorganisms may not be diagnosed and treated appropriately using conventional means.