Gastric Actinomycosis Case Report and Literature Review

Actinomycosis is an indolent infection that usually presents a diagnostic challenge to the physician. The most commonly affected zones are the cervicofacial, thoracic and abdominal areas. Abdominal actinomycosis although recognized for more than 150 years, is still wide unknown for most of the clinicians. Its various clinical manifestations are usually considered to present malignant process rather than infection. Intramural gastric actinomycosis is extremely rare clinical noosologic unit and usually the original source of infection is unknown. The usual clinical presentations include mild fever, epi- or mesogastric pain, weight loss, and bleeding from upper gastrointestinal tract. This chronic infection has tends to mimic malignancy. Gastric actinomycosis is very rare and with a good prognosis gastric disease. When established clinically, that is quite difficult diagnosis to be done before obtaining a surgical specimen. Although the findings are nonspecific, actinomycosis should be included in the differential diagnosis when CT scans show infiltrative mass with abnormal aggressiveness and dense enhancement of inhomogeneous contrast, especially in patients with leukocytosis, fever, or prolonged use of intrauterine contraceptives. We report a case of intramural gastric actinomycosis and review of cases of abdominal and gastric actinomycosis reported rarely in the literature. Reporting of such clinical case may help clinicians to increase the knowledge and awareness of this rare and treatable disease.