A Case of Pelvic Actinomycosis with Rectal Stricture in which Antibiotics was Effective

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  • NOGUCHI Takeharu
    Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital
  • EGUCHI Reiki
    Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital
  • YOSHITOSI Kenji
    Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital
  • TAKESHITA Nobuhiro
    Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital
  • KONDO Yasuyuki
    Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital
  • NAKAGAWA Ryosuke
    Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital
  • TAKAHASHI Manabu
    Department of Pathology, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital

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Other Title
  • 抗菌薬が奏効した直腸狭窄を伴う骨盤放線菌症の1例
  • 症例 抗菌薬が奏効した直腸狭窄を伴う骨盤放線菌症の1例
  • ショウレイ コウキンヤク ガ ソウコウ シタ チョクチョウ キョウサク オ トモナウ コツバン ホウセンキンショウ ノ 1レイ

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Abstract

The patient was a 65-year-old woman who complained of pyrexia and abdominal distension. She was referred to our hospital because a mass lesion in the rectum was detected by a computed tomography (CT) examination. White blood cell count and serum level of C protein reaction (CRP) increased to 13.900/μl and 5.48 mg/dl, respectively. Barium enema study revealed stricture of the rectum, and a colonoscopic study showed slight redness of the mucosa and the narrowed lumen of the rectum. She had an intrauterine device (IUD) inserted at the age of 35 where it remained without exchange thereafter. Therefore, antibiotic administration was immediately begun since actinomycosis was suspected and the IUD was removed. At that time, grains of actinomycetes were cytologically identified and the diagnosis of pelvic actinomycosis was made. Six months of oral ampicillin treatment improved the stricture of the rectum. It is necessary to carefully discuss the surgical criteria because surgical treatment in the early phase of inflammation may require extensive resection of the lesion and surrounding organs.

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