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Kidney non-tumor

Infections / parasites

Actinomycosis


Reviewers: Nikhil Sangle, M.D. (see Reviewers page)
Revised: 10 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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Actinomyces are anaerobic, gram-positive, non-acid fast filamentous bacteria that are normal flora in mouth, vagina, GI tract
● Cause chronic suppurative and granulomatous disease of cervico-facial, thoracic or abdominal region
● Sometimes called the most "misdiagnosed disease" because abscesses can mimic malignancy and may lead to unnecessary surgical resections (South Med J 2004;97:316, Am J Surg Pathol 2000;66:85)
Actinomyces israelii: usual cause of Actinomyces abscesses; also most common cause of disseminated actinomycosis, secondary to GI perforation (diverticulitis, appendicitis) or procedures, IUD, aspiration, poor oral hygiene / dental procedures

Case reports
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● 11 year old girl with 4 cm kidney tumor and multiple 1-2 mm lung nodules (Case of the Week #244)
● 39 year old man with sinus tracts (Radiology 2007;244:309)
● 46 year old woman with retroperitoneal mass (Infect Dis Obstet Gynecol 2011;2011:747059)
● 50 year old woman with solitary renal cyst (Indian J Urol 2008;24:416)
● 53 year old man with poor oral hygiene (Urol J 2010;7:80)
● 74 year old with coexisting renal vein thrombosis (Clin Nephrol 2012;77:156)

Treatment
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● Antibiotics; possibly nephrectomy

Gross images
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Actinomycosis of kidney

Micro description
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● Marked acute and chronic inflammation with occasional “sulfur granules”

Micro images
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11 year old girl

       
Retroperitoneal mass

End of Kidney non-tumor > Infections / parasites > Actinomycosis

Ref Updated: 9/4/12


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