Recognition of renal actinomycosis: nephrectomy can be avoided. Report of a case.

Nephrectomy is performed for the diagnosis and treatment of renal actinomycosis. A cachectic 62-year-old man with a left renal mass underwent exploration and needle biopsy of the mass. No malignant disease was found. When his condition further deteriorated, the kidney was re-explored. Numerous biopsies intraoperatively finally revealed actinomycosis, so the operation was terminated with preservation of the kidney. Long-term treatment with antibiotics was begun with immediate, marked improvement in the patient's condition. At 1 year the renal mass had almost resolved. This is the first reported case of the diagnosis and treatment of renal actinomycosis without nephrectomy.