Rectal actinomycosis mimicking malignancy

Abdominal actinomycosis is a chronic suppurative infection caused by Actinomyces species. The ileo-cecal region is most commonly affected, while the left side of the colon is more rarely involved. The infection has a tendency to infiltrate adjacent tissues and is, therefore, rarely confined to a single organ. Presentation may vary from non-specific symptoms and signs to an acute abdomen. We present a 56-year-old male who underwent a colonoscopy for complaints of bleeding per rectum that showed an ulcero-proliferative lesion at the recto-sigmoid junction that seemed like malignancy. Multiple biopsies done were reported this lesion to be Actinomycosis. He responded well to medical management that avoided a major surgical procedure.