Actinomycetoma of the colon presenting as abdominal wall abscess. Case report and review of the literature

Introduction and importance: Abdominal actinomycetoma is a rare and often a missed diagnosis by most of clinicians due to its rarity and different clinical presentations. It is caused by Actinomyces speces which are gram positive bacilli and normal commensal inhabitants of the human bronchial and gastrointestinal tracts. A.Israelli is responsible for disease in humans once the mucosal barrier is broken.

Case presentation: This case report presents an adult female patient who consulted for a localized abdominal wall mass of 3 weeks duration and the clinical exam was in favor of an abdominal wall abscess, but later found to be an actinomycotoma of the colon invading the abdominal wall and forming an abdominal wall abscess. Transverse colectomy and drainage of abscess was done and she improved well.

Clinical discussion: Actinomycosis is common in the tropical and subtropical area. However, this is the first case reported in Rwanda and prompt surgical treatment and antibiotherapy have led to a good clinical outcome.

Conclusion: Abdominal actinomycetoma should be considered as a differential diagnosis of any abdominal wall mass for patients with known risk factors and surgery and antibiotics are the only curative treatment.

Keywords: Abdomen; Abdominal wall; Actinomycetoma; Mycetoma.