A rare cause of chronic abdominal pain, weight loss and anemia: abdominal actinomycosis.

Abdominal actinomycosis is a subacute/chronic bacterial infection that affects different body regions. A 46-year-old female presenting with intermittent abdominal pain, nausea, vomiting, transient bowel obstruction, weight loss (18 kg), anemia, and hypoalbuminemia was evaluated in our clinic. Physical examination showed diffuse slight tenderness and a relatively fixed tender mass with ill-defined edges localized to the right lower quadrant. We did not make any specific diagnosis after complete laboratory, endoscopic and radiological investigations. We confirmed abdominal actinomycosis after explorative laparotomy and histopathological examination of biopsy specimen taken from the mesenterium and omentum. After long-term penicillin (6 months) treatment, significant clinical and laboratory improvement were observed. In conclusion, abdominal actinomycosis should be considered in the differential diagnosis of chronic inflammatory disease with mass lesion and intestinal obstruction.