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Actinomycosis Causing Recurrent Perianal Fistulae

Actinomycosis is a rare but easily curable infection that should be considered in the differential diagnosis of perianal fistulizing disease. We present the case of a 26-year-old woman with complex perianal fistulae, including trans-sphincteric and suprasphincteric fistulous tracts and a rectovagina...

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Detalles Bibliográficos
Autores principales: Ferreira Cardoso, Mariana, Carneiro, Carla, Carvalho Lourenço, Luís, Graça Rodrigues, Catarina, Folgado Alberto, Sara, Alagoa João, Ana, Rocha, Ricardo, Geraldes, Vasco, Costa, Ana, Reis, Jorge, Nunes, Vítor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American College of Gastroenterology 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5482912/
https://www.ncbi.nlm.nih.gov/pubmed/28670596
http://dx.doi.org/10.14309/crj.2017.82
Descripción
Sumario:Actinomycosis is a rare but easily curable infection that should be considered in the differential diagnosis of perianal fistulizing disease. We present the case of a 26-year-old woman with complex perianal fistulae, including trans-sphincteric and suprasphincteric fistulous tracts and a rectovaginal fistula, requiring multiple abscess drainages, seton placement, and antibiotic courses, with little improvement. After extensive investigation, Actinomyces spp. was identified in anal cytology. The patient underwent a 6-week course of intravenous penicillin followed by oral amoxicillin, with remarkable improvement. This case illustrates the importance of pursuing less common diagnoses in refractory complex perianal disease, such as actinomycosis.