Uncommon presentation: primary gastric actinomycosis.

We present the case of an 18-year-old woman admitted to our hospital with persistent epigastric pain lasting two months and a weight loss of approximately 5 kg during the same period. She had no history of alcohol, tobacco, steroid, anticoagulant, or nonsteroidal anti-inflammatory drug use. Investigations were initiated with informed consent. Laboratory test results were: hemoglobin, 13 g/dL; white blood cell count, 9000/μL; platelet count, 353000/μL; aspartate aminotransferase, 22 U/L; alanine aminotransferase, 19 U/L; and total bilirubin, 0.42 mg/dl. Upper gastrointestinal endoscopy was performed; the mucosa of the corpus was hyperemic, and the mucosa of the antrum had a nodular appearance (Figure 1). Endoscopic biopsies were obtained from the mucosa of the antrum and corpus. Histological examination of the specimens revealed gram-positive filamentous rods in the lamina propria with intact mucosa (Figure 2) which, supported by a positive test for Helicobacter pylori, resulted in a diagnosis of actinomycosis.