https://doi.org/10.4081/ahr.2026.208
Gallbladder and common bile duct actinomycosis: a comprehensive systematic review of literature
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Published: 17 September 2026
Gallbladder actinomycosis is a rare chronic bacterial infection caused by Actinomyces species, most commonly Actinomyces israelii. It is often diagnosed incidentally due to its nonspecific clinical presentation and unclear incidence. This systematic review aims tosummarize the clinical presentation, diagnosis, and management of gallbladder and bile duct actinomycosis. A systematic literature search was conducted in Google Scholar to identify English-language studies reporting actinomycosis involving the gallbladder or bile duct on September 18, 2025. Studies describing the clinical presentation, diagnosis, and management of biliary actinomycosis were included. Studies involving other organs, review articles, editorials, conference abstracts without sufficient clinical data, non-English publications, and articles published in predatory journals were excluded. Data were extracted and analyzed descriptively according to PRISMA 2020 guidelines. Twenty-four studies reporting 25 patients were included. The mean age of the patients was 60.7 years, with 14 males (56%) and 11 females (44%). Isolated right upper quadrant pain was reported in 9 patients (36%). The gallbladder was the most commonly involved site in 20 patients (80%), followed by the common bile duct in 3 patients (12%), with combined gallbladder and common bile duct involvement and cystic duct remnant involvement in 1 patient each (4%). Acute cholecystitis was the most frequent initial diagnosis in 9 patients (36%). Surgical management, with or without adjunctive medical therapy, was the primary treatment modality in 23 patients (92%). Histopathological examination consistently demonstrated filamentous, Grampositive branching bacilli in all 25 patients (100%). Gallbladder actinomycosis is rare and difficult to diagnose preoperatively. Histopathology confirms the diagnosis in most cases, and early recognition allows management with surgery and prolonged antibiotic therapy, which was associated with favourable outcomes.
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CRediT authorship contribution
Shewaz Tariq Latif, investigation, writing – original draft, formal analysis, validation. Berun A. Abdalla, conceptualization, supervision, investigation, writing – original draft, formal analysis, validation. Suhaib H. Kakamad, investigation, writing – review & editing, visualization. Sasan M. Ahmed, investigation, writing – review & editing, visualization; Dahat A. Hussein, investigation, writing – review & editing, visualization. Dilan Hikmat, conceptualization, methodology, investigation, writing – review & editing. Shvan H. Mohammed, conceptualization, methodology, investigation, writing – review & editing. All authors have read and approved the final manuscript.
Data Availability Statement
The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
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