Primary anterior abdominal wall actinomycosis

Actinomycosis of the anterior abdominal wall is rare. We report a 50-year-old diabetic man who presented with a left hypochondrial mass of three weeks duration associated with fever. Abdominal computed tomography showed a 2×4 cm mass projecting from the internal abdominal wall associated with surrounding inflammation. The mass did not decrease after a week of intravenous antibiotics. Excision of the mass and primary closure of the abdominal wall were performed. The mass involved the deep muscles of anterior abdominal wall. The omentum was adherent to the parietal peritoneum underneath the mass. Microscopical examination of the mass was consistent with actinomycosis. The postoperative period was uneventful and the patient recovered completely. The patient received penicillin for six months.