Caecum actinomycosis with acute abdomen: A case report

Abdominal actinomycosis, one of the causes of ileocaecal disorders, is usually considered when other more common clinical conditions have been excluded. Actinomycosis is a rare infectious bacterial disorder caused by the Actinomyces species. We present the case of a 38-year male Saudi soldier who presented with pain in the right iliac fossa since 4 days prior to presentation. This stabbing pain started gradually. Based on clinical examination and abdominal ultrasound findings, an appendectomy was performed. Histological examination revealed appendicular actinomycosis with lymphoid hyperplasia, serosa congestion, and filamentous bacteria in the appendicular lumen. The patient was treated with amoxicillin. During follow-up, contrast-enhanced abdominal computed tomography (CT) and magnetic resonance imaging (MRI) revealed a 4.3 × 2.9 cm thickened caecal wall. Thereafter, the patient underwent laparoscope-assisted ileocaecal resection with ileocolic anastomosis. The histological report revealed calcified food material in the diverticulum, with chronic inflammation without actinomycosis, which may have been eradicated by the previous antibiotic treatment.