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Research Article Open access CC BY 4.0

Appendiceal Actinomycosis Revealed in the Postpartum Period: A Case Report and Literature Review

Adil CHAOUNI, Marouane OUCHARQUI, Hajar KANDOUSSI, Sofia MCHICHOU, Hounaida MAHFOUD, Samir BARGACH, Yahia Zain Al Abidine KHEDID, Mohamed EL ABSI, El Mahjoub ECHARRAB, El Hassan El ALAMI EL FARICHA, Mohamed EL OUNANI

Asian Journal of Research in Surgery · pp. 395–400 · Published 1 Sep 2025

10.9734/ajrs/2025/v8i2312

Abstract

Appendiceal actinomycosis is a rare form of chronic infection caused by Actinomyces israelii, a commensal bacterium of the digestive and female genital tracts. Its clinical presentation is often atypical and nonspecific, making the diagnosis difficult, usually established postoperatively. We report the case of a 35-year-old woman admitted on the 30th day postpartum with right iliac fossa pain evolving over several days, associated with fever. A history of prolonged intrauterine device (IUD) use was noted. Imaging revealed an appendiceal mass, prompting urgent surgical exploration. Histological analysis revealed sulfur granules and filamentous bacilli, consistent with appendiceal actinomycosis. The patient received prolonged antibiotic treatment with amoxicillin for twelve months, with a favorable outcome. This case highlights the importance of considering this diagnosis in cases of chronic abdominal pain, especially in postpartum women, and emphasizes the benefit of combined medical-surgical management in advanced forms.

Actinomycosis antibiotic treatment postpartum subacute appendicitis surgery

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