Abstract
We have experienced a case of primary hepatic actinomycosis caused by Actinomyces israelii (A. israelii). A 79-year-old woman with a history of choledocholithiasis was admitted to a hospital with persistent fever as the chief complaint. A liver abscess was revealed by abdominal echo and CT. Branched gram-positive bacilli were detected in the percutaneous abscess drainage. The results of Kinyoun staining were negative. White irregular-shape colonies were observed after six days of anaerobic culture. A. israelii was identified using the ANC identification card (sysmex biomerieux) on VITEK2. The abscess was found to be reduced after drainage and antibiotics (Tazobactum/Piperacillin) administration. Although hepatic actinomycosis is relatively rare, we should keep in mind that these bacteria can cause liver abscess, particularly if the patient has a history of choledocholithiasis or abdominal surgery. It is very important for the detection of anaerobic bacteria such as A. israelii to appropriately transport specimens using an anaerobic porter. If we suspect the involvement of actinomyces bacteria, the culture period should be prolonged.
