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Thoracoabdominal actinomycosis associated with laparoscopic cholecystectomy and mimicking metastatic pulmonary malignancy
  1. Kriti Thapa1,
  2. Moumita Sarker2 and
  3. Paul Graman1
  1. 1Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA
  2. 2Department of Infectious Diseases, Mary Washington Healthcare, Fredericksburg, Virginia, USA
  1. Correspondence to Dr Kriti Thapa; kriti_thapa{at}


Actinomyces naeslundii is rarely isolated in cases of actinomycosis. We present a case of thoracoabdominal actinomycosis caused by inadvertent enterotomy and gallstone spillage during a laparoscopic cholecystectomy. The actinomycosis initially presented as recurrent episodes of pneumonia, shortness of breath and unintentional weight loss. Initial CT imaging demonstrated pleural thickening along the right lung base as well as ill-defined consolidation in the right lower lobe. Repeat CT imaging showed progression of the mass-like region of consolidation with extrapulmonary spread to involve the abdomen, retroperitoneum and retrohepatic areas. Treatment involved intravenous antibiotics with concurrent abscess drainage followed by oral antibiotics.

  • infectious diseases
  • infections
  • pancreas and biliary tract

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  • Contributors All authors conceived the manuscript. KT wrote the initial draft manuscript. MS and PG reviewed the draft and contributed to the content. All authors approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.