A case of actinomycosis of the ileocecal area caused by acute appendicitis *
The patient was a 17-year-old male with abdominal pain and fever of three weeks duration who had been referred to our hospital with a diagnosis of acute abdomen. On arrival, a fist size mass with slight tenderness was palpable in the right lower abdomen, and elevation of WBC and a high fever were noted. CT scan and US revealed a tumor lesion adjacent to the cecum. Appendicitis with abscess formation was considered as a possible diagnosis. Operative findings disclosed a necrotic appendix and severe inflammation extending to the adjacent cecum. Ileocecal resection was done and a drainage tube was inserted into the abscess space. Postoperatively, actinomyces israeli was detected in inflammatory tissue pathologically. The acute appendicitis was considered to have caused the following actinomycosis of tissue surrounding the appendix. Actinomycosis of the ileocecal area is rare, and differentiating actinomycosis from other inflammatory diseases is difficult. The possibility of occult actinomycosis should be considered in cases of appendicitis with abscess formation. (Accepted on January 24，2008)
