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Actinomycosis: Case report of an unusual cause of diaphragmatic herniation
Journal article   Open access   Peer reviewed

Actinomycosis: Case report of an unusual cause of diaphragmatic herniation

Andrew Hurwich, Christopher Pennell and Rajeev Prasad
International journal of surgery case reports, v 85, 106227
Aug 2021
DOI: https://doi.org/10.1016/j.ijscr.2021.106227
PMID: 34343798
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.ijscr.2021.106227View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Actinomycosis Case report Diaphragm hernia IPOM
We present a case of actinomycosis which resulted in a symptomatic diaphragmatic hernia requiring operative repair, an unusual complication not found in the literature. Actinomycosis is a chronic, slowly progressive infection caused by the bacterial genus Actinomyces which characteristically causes necrosis and abscess formation in a myriad of organ systems. A 5 year old male presented with nonspecific symptoms which were, after a short delay, identified as actinomycosis and treated with appropriate antibiosis. His infection was complicated by development of a diaphragmatic hernia, which subsequently became symptomatic and required surgical repair. While this diaphragmatic hernia is an unusual complication of actinomycosis not previously found in the literature, the patient's delayed diagnosis of the infection is typical. Surgical intervention was warranted for symptoms of the sequelae of the disease, not control of the disease itself. Laparoscopic repair of the multiple diaphragmatic defects was successful with a intraperitoneal on-lay biologic mesh, with resolution of symptoms. It is possible the need for surgical intervention in future cases of actinomycosis could be avoided with higher index of suspicion leading to earlier diagnosis. •Actinomycosis is an indolent, difficult to diagnose infection.•Actinomycosis causes a wide variety of pathology.•Intraperitoneal onlay mesh for repair of diaphragmatic hernia.

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Collaboration types
Domestic collaboration
Web of Science research areas
Surgery
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