Abdominopelvic actinomycosis: An unexpected diagnosis in an elderly female with a destructive-appearing soft tissue mass
Elise Hyser,
Drashti Antala,
Harvey Friedman,
Jonathan Stake
Affiliations
Elise Hyser
Department of Internal Medicine, AMITA Health St. Francis Hospital, 355 Ridge Avenue, Evanston, IL 60202, USA; Correspondence to: 147 Oakmont Drive, Deerfield, IL 60015, USA.
Drashti Antala
Department of Internal Medicine, AMITA Health St. Francis Hospital, 355 Ridge Avenue, Evanston, IL 60202, USA
Harvey Friedman
Department of Internal Medicine, AMITA Health St. Francis Hospital, 355 Ridge Avenue, Evanston, IL 60202, USA; Department of Pulmonary and Critical Care, AMITA Health St. Francis Hospital, 355 Ridge Avenue, Evanston, IL 60202, USA
Jonathan Stake
Department of Internal Medicine, AMITA Health St. Francis Hospital, 355 Ridge Avenue, Evanston, IL 60202, USA; Department of Infectious Disease, AMITA Health St. Francis Hospital, 355 Ridge Avenue, Evanston, IL 60202, USA
We present the case of an elderly female who underwent a workup for acute blood loss anemia that incidentally led to the discovery of abdominopelvic actinomycosis. While esophagogastroduodenoscopy and colonoscopy were unremarkable, CT abdomen/pelvis displayed a soft tissue mass in the left sacral ala and presacral area that appeared suspicious for malignancy. MRI pelvis revealed a presacral abscess, and an IR-guided biopsy cemented the diagnosis. This case exemplifies how actinomycosis can mimic the presentation of cancer. Risk factors included a history of ischemic colitis and lumbar laminectomy, as mucosal tissue compromise and orthopedic hardware can be niduses for infection.
