Uncommon Urinary Actinomycosis Mimicking Upper Urinary Tract Urothelial Tumor: Case Report and Literature Review

Urinary actinomycosis is a rare condition, often mimicking a urinary tract tumor. Due to its low prevalence, it can be challenging to diagnose and may be mistaken for malignancies. A 33-year-old female patient with a history of type 2 <i>Diabetes Mellitus</i> and recurrent urinary tract...

Full description

Saved in:
Bibliographic Details
Main Authors: Patricia A. Meza-Meneses, Rodrigo Pérez Becerra, Gerardo Garza Sainz, Luis Trujillo Ortiz, Adrián Martinez Correa, Alan Rodrigo Pérez Soriano, Ruben Miguel Angel Santiago González, Aarón Delgado Corral, Omar Vieyra Valdez, Genaro Argüelles Morales, Mario Alberto Toledo Díaz, Alberto Saldivar Luna, Carlos Alberto Castro-Fuentes, Victor Osornio Sánchez
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Microorganisms
Subjects:
Online Access:https://www.mdpi.com/2076-2607/13/5/1033
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849327132250996736
author Patricia A. Meza-Meneses
Rodrigo Pérez Becerra
Gerardo Garza Sainz
Luis Trujillo Ortiz
Adrián Martinez Correa
Alan Rodrigo Pérez Soriano
Ruben Miguel Angel Santiago González
Aarón Delgado Corral
Omar Vieyra Valdez
Genaro Argüelles Morales
Mario Alberto Toledo Díaz
Alberto Saldivar Luna
Carlos Alberto Castro-Fuentes
Victor Osornio Sánchez
author_facet Patricia A. Meza-Meneses
Rodrigo Pérez Becerra
Gerardo Garza Sainz
Luis Trujillo Ortiz
Adrián Martinez Correa
Alan Rodrigo Pérez Soriano
Ruben Miguel Angel Santiago González
Aarón Delgado Corral
Omar Vieyra Valdez
Genaro Argüelles Morales
Mario Alberto Toledo Díaz
Alberto Saldivar Luna
Carlos Alberto Castro-Fuentes
Victor Osornio Sánchez
author_sort Patricia A. Meza-Meneses
collection DOAJ
description Urinary actinomycosis is a rare condition, often mimicking a urinary tract tumor. Due to its low prevalence, it can be challenging to diagnose and may be mistaken for malignancies. A 33-year-old female patient with a history of type 2 <i>Diabetes Mellitus</i> and recurrent urinary tract infections presented to the emergency room with right renal fossa pain radiating to the right hypochondrium, fever with chills, nausea, and vomiting. Physical examination revealed a positive Giordano sign and tenderness at the ipsilateral middle and upper ureteral points. A contrast-enhanced CT scan showed a mass infiltrating the distal third of the right ureter, causing retrograde dilatation and hydronephrosis. Additionally, a liver injury with both liquid and solid components was observed. Therefore, given the suspicion of a urothelial tumor, a diagnostic cystoscopy and ureteroscopy were performed. Using interventional radiology, an abscessed liver lesion was drained, yielding purulent fluid. The histopathological examination revealed no evidence of malignancy. However, due to the strong suspicion of upper urinary tract urothelial carcinoma, a right radical nephroureterectomy with bladder cuff excision and retroperitoneal lymphadenectomy was performed. Histopathological examination ultimately confirmed urinary actinomycosis. Consequently, antibiotic therapy with oral amoxicillin 2 g every 12 h was initiated, leading to a good clinical response. Despite its low incidence, urinary actinomycosis should be considered as a differential diagnosis in cases suspected of urothelial tumors in the upper urinary tract. Increased awareness of this rare condition may help prevent unnecessary surgical interventions.
format Article
id doaj-art-03fe1bd454634eada33cb666b9824e04
institution Kabale University
issn 2076-2607
language English
publishDate 2025-04-01
publisher MDPI AG
record_format Article
series Microorganisms
spelling doaj-art-03fe1bd454634eada33cb666b9824e042025-08-20T03:47:58ZengMDPI AGMicroorganisms2076-26072025-04-01135103310.3390/microorganisms13051033Uncommon Urinary Actinomycosis Mimicking Upper Urinary Tract Urothelial Tumor: Case Report and Literature ReviewPatricia A. Meza-Meneses0Rodrigo Pérez Becerra1Gerardo Garza Sainz2Luis Trujillo Ortiz3Adrián Martinez Correa4Alan Rodrigo Pérez Soriano5Ruben Miguel Angel Santiago González6Aarón Delgado Corral7Omar Vieyra Valdez8Genaro Argüelles Morales9Mario Alberto Toledo Díaz10Alberto Saldivar Luna11Carlos Alberto Castro-Fuentes12Victor Osornio Sánchez13Infectology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoResearch Unit, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrology Service, Hospital Regional de Alta Especialidad de Ixtapaluca, Servicios de Salud del Instituto Mexicano de Seguro Social Para el Bienestar (IMSS-BIENESTAR), Carretera Federal Mexico-Puebla Km 34.5, Ixtapaluca 56530, MexicoUrinary actinomycosis is a rare condition, often mimicking a urinary tract tumor. Due to its low prevalence, it can be challenging to diagnose and may be mistaken for malignancies. A 33-year-old female patient with a history of type 2 <i>Diabetes Mellitus</i> and recurrent urinary tract infections presented to the emergency room with right renal fossa pain radiating to the right hypochondrium, fever with chills, nausea, and vomiting. Physical examination revealed a positive Giordano sign and tenderness at the ipsilateral middle and upper ureteral points. A contrast-enhanced CT scan showed a mass infiltrating the distal third of the right ureter, causing retrograde dilatation and hydronephrosis. Additionally, a liver injury with both liquid and solid components was observed. Therefore, given the suspicion of a urothelial tumor, a diagnostic cystoscopy and ureteroscopy were performed. Using interventional radiology, an abscessed liver lesion was drained, yielding purulent fluid. The histopathological examination revealed no evidence of malignancy. However, due to the strong suspicion of upper urinary tract urothelial carcinoma, a right radical nephroureterectomy with bladder cuff excision and retroperitoneal lymphadenectomy was performed. Histopathological examination ultimately confirmed urinary actinomycosis. Consequently, antibiotic therapy with oral amoxicillin 2 g every 12 h was initiated, leading to a good clinical response. Despite its low incidence, urinary actinomycosis should be considered as a differential diagnosis in cases suspected of urothelial tumors in the upper urinary tract. Increased awareness of this rare condition may help prevent unnecessary surgical interventions.https://www.mdpi.com/2076-2607/13/5/1033urinary actinomycosisurothelial tumorurinary tractcase reportmisdiagnosedmimicking
spellingShingle Patricia A. Meza-Meneses
Rodrigo Pérez Becerra
Gerardo Garza Sainz
Luis Trujillo Ortiz
Adrián Martinez Correa
Alan Rodrigo Pérez Soriano
Ruben Miguel Angel Santiago González
Aarón Delgado Corral
Omar Vieyra Valdez
Genaro Argüelles Morales
Mario Alberto Toledo Díaz
Alberto Saldivar Luna
Carlos Alberto Castro-Fuentes
Victor Osornio Sánchez
Uncommon Urinary Actinomycosis Mimicking Upper Urinary Tract Urothelial Tumor: Case Report and Literature Review
Microorganisms
urinary actinomycosis
urothelial tumor
urinary tract
case report
misdiagnosed
mimicking
title Uncommon Urinary Actinomycosis Mimicking Upper Urinary Tract Urothelial Tumor: Case Report and Literature Review
title_full Uncommon Urinary Actinomycosis Mimicking Upper Urinary Tract Urothelial Tumor: Case Report and Literature Review
title_fullStr Uncommon Urinary Actinomycosis Mimicking Upper Urinary Tract Urothelial Tumor: Case Report and Literature Review
title_full_unstemmed Uncommon Urinary Actinomycosis Mimicking Upper Urinary Tract Urothelial Tumor: Case Report and Literature Review
title_short Uncommon Urinary Actinomycosis Mimicking Upper Urinary Tract Urothelial Tumor: Case Report and Literature Review
title_sort uncommon urinary actinomycosis mimicking upper urinary tract urothelial tumor case report and literature review
topic urinary actinomycosis
urothelial tumor
urinary tract
case report
misdiagnosed
mimicking
url https://www.mdpi.com/2076-2607/13/5/1033
work_keys_str_mv AT patriciaamezameneses uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT rodrigoperezbecerra uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT gerardogarzasainz uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT luistrujilloortiz uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT adrianmartinezcorrea uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT alanrodrigoperezsoriano uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT rubenmiguelangelsantiagogonzalez uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT aarondelgadocorral uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT omarvieyravaldez uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT genaroarguellesmorales uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT marioalbertotoledodiaz uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT albertosaldivarluna uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT carlosalbertocastrofuentes uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview
AT victorosorniosanchez uncommonurinaryactinomycosismimickingupperurinarytracturothelialtumorcasereportandliteraturereview