A case of hepatic actinomycosis caused by <i>Actinomyces israelii</i> diagnosed at an early stage by percutaneous hepatic drainage

DOI
  • YAMAGUCHI Kenta
    Department of Clinical Laboratory, Saga-ken Medical Centre Koseikan
  • DOI Marie
    Department of Clinical Laboratory, Saga-ken Medical Centre Koseikan
  • OSOEGAWA Kouichi
    Department of Clinical Laboratory, Saga-ken Medical Centre Koseikan
  • KISHIKAWA Kyouko
    Department of Clinical Laboratory, Saga-ken Medical Centre Koseikan
  • YOSHIDA Midori
    Department of Clinical Laboratory, Saga-ken Medical Centre Koseikan
  • ABE Michi
    Department of Clinical Laboratory, Saga-ken Medical Centre Koseikan

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  • 経皮肝生検の塗抹検査によって早期に診断できた<i>Actinomyces israelii</i>による原発性肝放線菌症の1例

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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.

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