Abdominal Actinomycosis Abscess Presenting as an Isolated Gastrointestinal Pseudotumor

Actinomyces is a gram-positive anaerobic bacterium that is ubiquitous in nature. It typically presents as respiratory, cervicofacial, or abdominopelvic abscesses. We present a 66-year-old man with a progressive enlarging abdominal wall nodule concerning for malignancy. The patient had a negative workup, including an ultrasound-guided fine-needle aspiration and colonoscopy, with biopsy for a possible extension to the colonic wall. Diagnosis of an Actinomyces abscess was obtained through surgical resection with right hemicolectomy. He was successfully treated with a prolonged course of intravenous antibiotics. This is a rare case of an isolated abdominal wall Actinomyces abscess mimicking a gastrointestinal malignancy.