ABDOMINAL ACTINOMYCOSIS (CLINICAL CASE)
Introduction. Actinomycosis is a chronic purulent disease with the formation of specific granulomas in soft tissues and bones, followed by the formation of abscesses and the possible recurrence of fistulas during further development. Case report. Patient of 30 years old. From 2010-2011 were performed a multiple drainages of liver abscesses. In April 2012 relapsed of liver abscess, abdomino-bronchial fistula. The abscess was drained, appointed course of antibiotic therapy. In October 2012 - a relapse of the abscess of the right lobe of the liver with abdominopleural fistula. In December 2012 was performed the operation: cryodestruction of the tumor node. Histological material: chronic abscess of nonspecific etiology. Microorganisms from the cavity of abscess were not revealed. After 1 month there was a relapse of the abscess in the right lobe of the liver with a size of 74×24 mm. A puncture of abscess was performed. Microorganisms from the abscess cavity were not revealed again. In April 2013 were found multiple abscesses of the right lobe of the liver. Right hemihepatectomy was performed. Detected Streptococcus sp. In May 2013 revealed an abscess in the area of resection, draining in the right subdiaphragmatic space. Detected Actinomyces sp. in a pus. After antibacterial treatment with amoxiclav the cavity of abscess was decreased and fistula closed. In April 2014 - another relapse. Actinomyces sp. detected again. The patient was treated with Amoxiclav 325 mg (2 times a day) for two months with subsequent withdrawal of the drug. A month later on the background of the abolition of therapy was detected the abscess of the subdiaphragmatic space. Amoxiclav was appointed again and was recommended a constant reception. In December 2017 (25 months after discharge) there was not data for relapse of abscesses. Antibiotic therapy have been continuing. Conclusions. Actinomycosis should be excluded when liver abscesses recurring. The treatment of the disease is complex: surgical treatment, long-term antibiotic therapy. The sensitivity of actinomycetes to antibiotic therapy with penicillin does not change with the time. The duration of antibiotic therapy of actinomycosis requires further study.