Cover Image

Actinomycosis of the Gallbladder: A Case Report

Chih-Yuan Cheng, Hung-Kan Tseng, Shing-Jhong Long, Shih-Sung Chuang, Shien-Tung Pan


Introduction: Actinomycosis of the gallbladder is extremely rare and may mimic a malignancy leading to delayed diagnosis and/or inappropriate treatment.

Presentation of case: Here we report the case of an 82-year-old man who presented with right upper abdominal discomfort for one month. Radiographically, an ill-defined mass was found in the gallbladder fossa that invaded the adjacent abdominal wall and liver bed. In addition, a stone was found in the gallbladder lumen. The imaging features suggested a gallbladder carcinoma. An initial CT-guided needle biopsy showed an inflammatory process. The subsequent open cholecystectomy revealed a contracted, thick-walled gallbladder surrounded by a soft tissue mass near the fundus. Histologically, the gallbladder revealed acute and chronic cholecystitis and microabscesses containing sulfur granules in the soft tissue mass, which showed Gram-positive filamentous bacilli. Under the diagnosis of gallbladder actinomycosis, the patient received post-operative antibiotics for 7 weeks and was well 5 months after diagnosis.

Conclusion: Our case demonstrated that a gallbladder actinomycosis should be considered in the differential diagnosis in patients with cholelithiasis and cholecystitis presenting an invasive mass in the gallbladder fossa.


Actinomycosis; Gallbladder carcinoma; Taiwan

Full Text:



MoniruddinABM, Begum H, Nahar K. Actinomycosis: an update. Medicine Today. 2010, 22:43-47

Smego RA, Foglia G Actinomycosis. Clin Infect Dis. 1998, 26:1255-1263

Lee YH, Kim SH, Cho MY, Rhoe BS, Kim MS. Actinomycosis of the gallbladder mimicking carcinoma: a case report with US and CT findings. Korean J Radiol. 2007, 8: 169-172

Kuo YH, Hsieh PS, Changchien CR, Chen JS, Tang RP, Wang JY, Chiang JM, Yeh CY, Tsai WS, Hung HY. Abdominopelvic actinomycosis-treatment outcomes at the Chang Gung Memorial Hospital during the past 16 years. J Soc Colon Rectal Surgeon (Taiwan). 2009, 20:49-55

Al-Sindi K, El-Shenawi H, Al-Hilli F. Actinomycosis of the gallbladder. Bahrain Med Bull. 2006, 28:1-7

Mir Y, McLaughlin E, Campbell F, Azadeh B. Actinomycosis of the gallbladder: a case report. Open Mycol J. 2008, 2:105-107

Lee IJ, Ha HK, Park CM, Kim JK, Kim JH, Kim TK, Kim JC, Cho KS, Auh YH. Abdominopelvic actinomycosis involving the gastrointestinal tract: CT features. Radiol. 2001, 220:76-80

Fu PK, Tsai CA. Management of patients with huge pelvic actinomycosis complicated with hydronephrosis: a case report. J Microbiol Immunol Infect. 2010, 43:442-446

Bae SY, Lee JH, Park JY, Kim D, Min BH, Rhee PL, Kim JJ. Clinical significance of serum CA-125 in Korean females with ascites. Yonsei Med J. 2013, 54:1241-1247

Hefny AF, Torab FC, Joshi S, Sebastian M, Abu-Zidan FM. Actinomycosis of the gallbladder: case report and review of the literature. Asian J Surg. 2005, 28:230-232


  • There are currently no refbacks.

AJCC-REP (ISSN 2572-5742)Copyright © 2012-2021. All rights reserved. Published by Ivy Union Publishing, 3204 Valley Rush Dr, Apex, North Carolina 27502, United States