A Case of Intrapelvic Actinomycosis for which a Penicillin Antibiotic was Effective

Received: July 11, 2011/Accepted: July 28, 2011 Correspondence to: Minoru Fujisawa Department of General Surgery, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo 1778521, Japan Abstract We encountered a patient with intrapelvic actinomycosis accompanied by sigmoid colon stenosis for which oral antibiotic treatment was effective. The patient was a 66-year-old female who visited a physician for a chief compliant of right lower abdominal pain. On abdominal CT, an irregular mass accompanied by right hydronephrosis was noted in the right pelvic cavity, and the patient was referred to our department. On the contrast enema of the sigmoid colon, serrated stenosis was noted in the sigmoid colon over the rectum, and a colonoscope could not be passed through. Thus, surgery was performed. Since dissection was difficult because of the sigmoid colon, rectum and swallowing origin was involved to the broad granulomatous mass, resection was gived up and colostomy was applied to the descending colon. Actinomycetes was detected in the excised sample, and intrapelvic actinomycosis was diagnosed, for which oral amoxicillin was continuously administered for 6 months. Then, the granulomatous mass disappeared, and right hydronephrosis improved on CT scan, colostomy was closed because sigmoid colon stenosis had improved on contrast enema.