Hepatic actinomycosis: Report of one case and analysis of 32 previously reported cases

Table 1 Basic information about the hepatic actinomycosis patient n (%)

Age (yr)	45.5 ± 21.12 (5-86)
Gender (male/female)	19/13
Duration (d)	82.3 ± 96.6 (3-365)
Median (d)	37.5
Combined diseases	191 (59.4)
Diabetics	5 (15.6)
Previous history of abdominal surgery and trauma2	9 (28.1)
Pancreatitis	3 (9.4)
Oral diseases	3 (9.4)
IUD	2 (6.3)
Drinking	1 (3.1)
Asthma	1 (3.1)
Gastroesophageal Reflux	1 (3.1)
Diverticulitis	1 (3.1)
Chickenpox	1 (3.1)
Fever	25/27 (92.6)
Weight loss	15/25 (60.0)
Anemia	17/24 (70.8)
Peripheral blood WBC and/or neutralization increased	27/29 (93.1)
Diagnostic methods
Liver puncture fluid	19/32 (59.4)
Liver puncture biopsy	4/32 (12.5)
Liver lobe resection	6/32 (18.7)
Others (fiberscopic lung biopsy, pleura biopsy and ovariotomy, 1 case each)
	3/32 (9.45)
Misdiagnosed
Liver malignant tumor	20/28 (71.4)
Hepatophyta	8/28 (28.6)
Liver hydatidosis	2/28 (7.1)
Others3	2/28 (7.1)
Treatments
Surgery or puncture drainage + anti-infection	12/32 (37.5)
Liver lobe resection + anti-infection	6/32 (18.7)
Anti-infection alone	14/32 (43.8)

¹Some patients had multiple complications;

²The abdominal surgeries included the gastroesophageal surgery, appendicitis surgery, stent placement for chronic pancreatitis, biliary tract surgery and ectopic pregnancy surgery; 1 case was accompanied with a history of chest and abdomen trauma;

³Hepatic inflammatory pseudotumor and tuberculosis had 1 case, respectively.

Table 2 Imaging characteristic of hepatic actinomycosis

Imaging characteristic (cases)	n (%)
Imaging characteristics (32)
Low density	22 (68.8)
Abscess-like	6 (18.7)
Cystic	2 (6.3)
Mass-like and nodular	2 (6.3)
Lesion numbers (29)
Single	21 (72.4)
Multiple	8 (27.6)
Lesion distribution (29)
Liver right lobe	19 (65.5)
Liver left lobe	2 (6.9)
Liver right and left lobes	8 (27.6)

Table 3 Pathological and aetiological diagnosis of hepatic actinomycosis

Diagnostic method (cases)	n (%)
Histodiagnosis (31)
Sulfur granules	22 (71.0)
Etiological diagnosis
Gram staining (27)	22 (81.5)
Cultivation (20)
Actinomyces	10 (50.0)
Other bacteria	3 (15)
Mixed infection	4 (20)