Authors
P Baburaj1, Thomson Antony1, C S Madhu1, Harikrishnan B L1
1Department of Medicine, Jubilee Mission Medical College & Research Institute, East Fort, Thrissur, Kerala.
Abstract
Background: Renal actinomycosis is a rare infection, often mimicking other renal pathologies or presenting as pyrexia of unknown origin (PUO), posing significant diagnostic challenges. Only about 50 cases have been reported globally since 1878.
Case Presentation: A 55-year-old male presented with a four-month history of low-grade fever, weight loss, and anorexia. Physical examination revealed a left lumbar mass. Imaging studies (ultrasound, CT, MRI) identified a mass lesion in the upper pole of the left kidney, leading to a provisional diagnosis of renal cell carcinoma or pseudotumour.
Diagnosis and Intervention: The patient underwent left nephrectomy. Histopathological examination of the resected kidney confirmed chronic suppurative inflammation consistent with actinomycosis.
Outcome: Postoperative recovery was uneventful. The patient received intravenous crystalline penicillin for 14 days, followed by oral antibiotics for a total of eight weeks, resulting in complete resolution of symptoms and normalization of inflammatory markers.
Conclusion: This case underscores renal actinomycosis as a rare cause of PUO and a renal mass. Definitive diagnosis typically relies on histopathology after surgical intervention. Timely diagnosis and prolonged antibiotic therapy are essential for successful management.