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Actinomycosis Causing Recurrent Perianal Fistulae

2017; Lippincott Williams & Wilkins; Volume: 4; Issue: 1 Linguagem: Inglês

10.14309/crj.2017.82

2326-3253

Mariana Cardoso, Carla Carneiro, Luís Carvalho Lourenço, Catarina Rodrigues, S Alberto, Ana Alagoa João, Ricardo Rocha, Vasco Geraldes, Ana Maria Massad Costa, Jorge Reis, Vítor Nunes,

IgG4-Related and Inflammatory Diseases

Actinomycosis is a rare but easily curable infection that should be considered in the differential diagnosis of perianal fistulizing disease. We present the case of a 26-year-old woman with complex perianal fistulae, including trans-sphincteric and suprasphincteric fistulous tracts and a rectovaginal fistula, requiring multiple abscess drainages, seton placement, and antibiotic courses, with little improvement. After extensive investigation, Actinomyces spp. was identified in anal cytology. The patient underwent a 6-week course of intravenous penicillin followed by oral amoxicillin, with remarkable improvement. This case illustrates the importance of pursuing less common diagnoses in refractory complex perianal disease, such as actinomycosis.