Sonographiegesteuerte Feinnadelpunktion von Abszessen bei   abdomineller Aktinomykose

H. Weiler; A. Grandel; J. Dürre

doi:10.1055/s-2002-20074

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Ultraschall Med 2002; 23(1): 52-56
DOI: 10.1055/s-2002-20074

Kasuistik

Sonographiegesteuerte Feinnadelpunktion von Abszessen bei abdomineller Aktinomykose

Sonographically Guided Fine-Needle Aspiration of Abscesses in Cases of Abdominal ActinomycosisH. Weiler¹ , A. Grandel¹ , J. Dürre²

¹ Medizinische Klinik I - Schwerpunkt Gastroenterologie/Hepatologie (Ärztlicher Direktor: Prof. Dr. med. P. Frühmorgen), Klinikum Ludwigsburg
² Pathologisches Institut (Ärztlicher Direktor i. R.: Prof. Dr. med. H. Seeliger), Klinikum Ludwigsburg

Further Information

Publication History

13. 8. 2001

16. 10. 2001

Publication Date:
13 August 2002 (online)

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Zusammenfassung

Wir berichten über zwei Fälle einer isolierten abdominellen Aktinomykose. a) Ein 52-jähriger Patient mit einem peripankreatisch gelegenen Abszess im Bereich des Pankreasschwanzes. Dieser Abszess entstand in einem Zeitraum von zwei Jahren nach laparoskopischer Cholezystektomie mit postoperativer Peritonitis und Relaparotomie. b) Ein 19-jähriger Patient mit perityphlitischem Abszess, der nach Appendektomie wegen Appendizitis auftrat. Die definitive Diagnose der intraabdominellen Aktinomykose erfolgte nach sonographiegesteuerter Feinnadelpunktion. In beiden Fällen ergab die bakteriologische Untersuchung des Abszesssekretes Actinomyces (A.) israelii. Als Begleitkeime ließen sich im Fall a) Klebsiella und Actinobacter species, im Fall b) Hämophilus (Actinobacillus) actinomycetem comitans nachweisen. Lichtmikroskopisch fanden sich Aktinomyzeten-Drusen. Bei beiden Patienten konnte nach chirurgischer Intervention und Antibiotikatherapie eine Kuration der Aktinomykose erreicht werden.

Abstract

This report describes two cases of isolated abdominal actinomycosis. a) A 52-year-old man developed a peripancreatic abscess in the course of two years after laparoscopic cholecystectomy and repeated laparotomy because of postoperative peritonitis. b) A 19-year-old man, who had a perityphlitic abscess following appendectomy performed because of appendicitis. The definitive diagnosis of abdominal actinomycosis was confirmed by percutaneous ultrasound-guided fine-needle aspiration: In both cases culture of the aspirated material yielded Actinomyces (A.) israelii. As concomitant microflora we found Klebsiella and Actinobacter species in the first case and Haemophilus (Actinobacillus) actinomycetem comitans in the other case. “Sulfur granules” obtained from the pus showed histological aggregates of Actinomyces in both cases. After surgical treatment and antibiotic therapy, both patients recovered completely.

Schlüsselwörter

Abdominelle Aktinomykose - Abszess

Key words

Abdominal actinomycosis - Abscess

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PD Dr. Dr. H. Weiler

Medizinische Klinik · Klinikum Ludwigsburg

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