Appendiceal Actinomycosis Revealed in the Postpartum Period: A Case Report and Literature Review
Adil CHAOUNI
Department of Emergency Digestive Surgery, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
Marouane OUCHARQUI
Department of Emergency Digestive Surgery, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
Hajar KANDOUSSI *
Department of Gynecology Obstetrics, Maternity Souissi, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
Sofia MCHICHOU
Department of Gynecology Obstetrics, Maternity Souissi, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
Hounaida MAHFOUD
Department of Gynecology Obstetrics, Maternity Souissi, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
Samir BARGACH
Department of Gynecology Obstetrics, Maternity Souissi, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
Yahia Zain Al Abidine KHEDID
Department of Emergency Digestive Surgery, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
Mohamed EL ABSI
Department of Emergency Digestive Surgery, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
El Mahjoub ECHARRAB
Department of Emergency Digestive Surgery, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
El Hassan El ALAMI EL FARICHA
Department of Emergency Digestive Surgery, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
Mohamed EL OUNANI
Department of Emergency Digestive Surgery, Ibn Sina University Hospital Center, Mohammed V University, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Appendiceal actinomycosis is a rare form of chronic infection caused by Actinomyces israelii, a commensal bacterium of the digestive and female genital tracts. Its clinical presentation is often atypical and nonspecific, making the diagnosis difficult, usually established postoperatively. We report the case of a 35-year-old woman admitted on the 30th day postpartum with right iliac fossa pain evolving over several days, associated with fever. A history of prolonged intrauterine device (IUD) use was noted. Imaging revealed an appendiceal mass, prompting urgent surgical exploration. Histological analysis revealed sulfur granules and filamentous bacilli, consistent with appendiceal actinomycosis. The patient received prolonged antibiotic treatment with amoxicillin for twelve months, with a favorable outcome. This case highlights the importance of considering this diagnosis in cases of chronic abdominal pain, especially in postpartum women, and emphasizes the benefit of combined medical-surgical management in advanced forms.
Keywords: Actinomycosis, antibiotic treatment, postpartum, subacute appendicitis, surgery