A Case of Abdominal Actinomycosis After Surgery for Perforating Appendicitis

Abstract

An 81-year-old woman underwent an appendectomy with abdominal irrigation for perforating appendicitis. She visited our hospital complaining of right abdominal pain 2 months after the surgery. Computed tomography revealed a high density area in the right abdomen, and an abdominal abscess was suspected. Antibiotics (levofloxacin) were administered to the patient. One week later, abdominal pain was not relieved, so we performed curettage of the abdominal abscess. During the operation, we detected granulation tissue inside the abscess in the paracolic gutter. Postoperatively, based on the histopathological findings, we diagnosed the patient’s condition as abdominal actinomycosis after surgery for perforating appendicitis. We could not resect those granulation tissues completely, so we administered antibiotics （amoxicillin） to the patient for 6 months. Actinomycosis should be considered in the management of an abdominal abscess after surgery for perforating appendicitis.