51
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Stabrowski T, Chuard C. [Actinomycosis]. Rev Med Suisse 2019; 15:1790-1794. [PMID: 31599519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Actinomycosis is a chronic bacterial infection, caused by the genus Actinomyces, commensal of the digestive and genital tract. The most common presentation of the disease affects the cervicofacial region, but other anatomical sites in the abdomen, thorax and central nervous system may be involved. Differential diagnosis includes neoplasia. Prolonged culture of deep samples in an anaerobic environment is the gold standard of the diagnosis. The treatment of choice is intravenous penicillin G followed by oral amoxicillin for a total duration of 6 to 12 months. However, depending on the location and response to antibiotics, shorter therapy may be considered.
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Affiliation(s)
- Tatiana Stabrowski
- Clinique de médecine interne, HFR Fribourg - Hôpital cantonal, 1708 Fribourg
| | - Christian Chuard
- Service d'infectiologie, Clinique de médecine interne, HFR Fribourg - Hôpital cantonal, 1708 Fribourg
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Yun SS, Cho HS, Heo M, Jeong JH, Lee HR, Ju S, Kim JY, You JW, Cho YJ, Jeong YY, Kim HC, Lee JD, Lee SJ. Lung abscess by Actinomyces odontolyticus and Parvimonas micra co-infection presenting as acute respiratory failure: A case report. Medicine (Baltimore) 2019; 98:e16911. [PMID: 31464925 PMCID: PMC6736456 DOI: 10.1097/md.0000000000016911] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Actinomyces odontolyticus and Parvimonas micra are very rare causative organisms of lung abscess and acute respiratory failure. PATIENT CONCERNS A 49-year-old male patient visited the emergency room with a complaint of sudden onset of shortness of breath, and he developed acute respiratory failure rapidly. DIAGNOSIS An abscess in the left lower lung field was diagnosed on the computed tomography scan of chest. INTERVENTIONS Immediate treatment with intravenous antibiotics was initiated along with a pigtail catheter insertion for pus drainage. OUTCOMES A odontolyticus was cultured on the drained pus and P micra was identified by a blood culture. The patient was successfully weaned from the mechanical ventilator and the lung abscess was completely resolved. LESSONS To the best of our knowledge, this is the first case report of mixed infection with A odontolyticus and P micra, which caused acute respiratory failure in an immune-competent patient. Therefore, physicians should consider the possibility of these organisms as causative pathogens of a fulminant pulmonary infection even in an immune-competent patient.
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Affiliation(s)
| | - Hyun Seop Cho
- Division of Nephrology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | | | | | | | - Sunmi Ju
- Division of Pulmonology and Allergy
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Link PJ, Stiles ZE, Kaminsky J, Dill D, Mazumder S, Deneve JL. Ruptured Appendicitis and a Palpable Mass: Delayed Presentation of Appendiceal Actinomycosis. Am Surg 2019; 85:e208-e210. [PMID: 31043216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Affiliation(s)
- Yiyan Liu
- Nuclear Medicine Service, Department of Radiology, New Jersey Medical School, Rutgers University, Newark, NJ.
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Palmitessa V, Cuppone R, Monno R, Fumarola L, Lippolis A. A case report of esophageal actinomycosis in an immunocompetent patient and review of the literature. New Microbiol 2019; 42:55-60. [PMID: 30785207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 04/08/2019] [Indexed: 06/09/2023]
Abstract
Actinomycosis is a rare, chronic and slowly progressive granulomatous disease caused by Actinomyces spp., a Gram-positive anaerobic bacterium that rarely affects the esophagus. Although this infection is uncommon, it has been reported in both immunocompromised and immunocompetent individuals. The infection is often misdiagnosed because it can mimic other pathological conditions (like neoplasms and candidiasis), and Actinomyces is difficult to isolate because it requires specific growth conditions. However, actinomycosis has a favorable course if the microbiological diagnosis is timely. We report a case of esophageal actinomycosis in an immunocompetent 23-year-old man. The patient was admitted with symptoms of gastro-esophageal reflux disease (GERD), that had subsequently worsened. Histological and microbiological investigations revealed the presence of Actinomyces spp. A review of the literature regarding the clinical features, diagnosis, and management of this infection is also discussed.
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Affiliation(s)
- Valeria Palmitessa
- Laboratory of Microbiology and Virology, National Institute of Gastroenterology "S. De Bellis", Research Hospital, Castellana Grotte, Bari 70013, Italy
| | - Renato Cuppone
- Department of Gastroenterology, National Institute of Gastroenterology "S. De Bellis", Research Hospital, Castellana Grotte, Bari 70013, Italy
| | - Rosa Monno
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, 70124, Italy
| | - Luciana Fumarola
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, 70124, Italy
| | - Antonio Lippolis
- Laboratory of Microbiology and Virology, National Institute of Gastroenterology "S. De Bellis", Research Hospital, Castellana Grotte, Bari 70013, Italy
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Loukil M, Khalfallah I, Bouzaidi K, Chelbi E, Ghrairi H. [Pulmonary actinomycosis. Diagnostic and therapeutic features]. Rev Pneumol Clin 2018; 74:508-513. [PMID: 29859741 DOI: 10.1016/j.pneumo.2018.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 03/29/2018] [Accepted: 05/02/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Actinomycosis is a rare suppurative infection, subacute or chronic caused by bacteria of the genus Actinomyces. OBSERVATIONS A case study of 4 patients with prolonged respiratory symptoms. The clinical examination was poor in all cases. The CT-scan showed, in all cases, a suspicious tissue mass. The bronchoscopy diagnosis showed, in 2 cases, a tumor budding and was normal for the 2 other cases. Bronchial biopsies were negative in all cases. Before the prolonged symptomatology, the poor general condition, the endoscopic and the CT aspects; there was a suspect around a pulmonary neoplasia diagnosis, thus raising the need of a surgical treatment for diagnostic and therapeutic purposes. The anatomopathological examination of the resected specimen was in favour of the actinomycosis. The aim of these observations is to draw the attention to the radio-clinical, histological, therapeutic and evolutive aspects as well as the diagnostic difficulties of this condition. CONCLUSION The radio-clinical presentation of the actinomycosis is often misleading, thus a diagnostic confirmation is required before any useless surgical resection.
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Affiliation(s)
- M Loukil
- Service de pneumologie, hôpital Mohamed Tahar Maamouri, Nabeul, Tunisie; Faculté de médecine de Tunis, université El manar, Tunisie.
| | - I Khalfallah
- Service de pneumologie, hôpital Mohamed Tahar Maamouri, Nabeul, Tunisie; Faculté de médecine de Tunis, université El manar, Tunisie
| | - K Bouzaidi
- Service de radiologie, hôpital Mohamed Tahar Maamouri, Nabeul, Tunisie; Faculté de médecine de Tunis, université El manar, Tunisie
| | - E Chelbi
- Service d'anatomopathologie, hôpital Mohamed Tahar Maamouri, Nabeul, Tunisie; Faculté de médecine de Tunis, université El manar, Tunisie
| | - H Ghrairi
- Service de pneumologie, hôpital Mohamed Tahar Maamouri, Nabeul, Tunisie; Faculté de médecine de Tunis, université El manar, Tunisie
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Peiffer-Smadja N, Harent S, Messeca C, Lechapt-Zalcman E, Yazdanpanah Y, Joly V. A case of thoracic actinomycosis presenting as sudden paraplegia. Rev Neurol (Paris) 2018; 175:89-92. [PMID: 30309660 DOI: 10.1016/j.neurol.2018.01.380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 11/18/2022]
Affiliation(s)
- N Peiffer-Smadja
- Hôpital Bichat-Claude-Bernard, Assistance publique-Hôpitaux de Paris, 75877 Paris, France; Inserm, IAME, UMR 1137, université Paris Diderot, 75870 Paris, France.
| | - S Harent
- Hôpital Bichat-Claude-Bernard, Assistance publique-Hôpitaux de Paris, 75877 Paris, France
| | - C Messeca
- Hôpital Bichat-Claude-Bernard, Assistance publique-Hôpitaux de Paris, 75877 Paris, France
| | - E Lechapt-Zalcman
- Centre Hospitalier Saint-Anne, Assistance publique-Hôpitaux de Paris, 75014 Paris, France
| | - Y Yazdanpanah
- Hôpital Bichat-Claude-Bernard, Assistance publique-Hôpitaux de Paris, 75877 Paris, France; Inserm, IAME, UMR 1137, université Paris Diderot, 75870 Paris, France
| | - V Joly
- Hôpital Bichat-Claude-Bernard, Assistance publique-Hôpitaux de Paris, 75877 Paris, France
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Abstract
A 75-year-old man visited our hospital complaining of a low-grade fever, dry cough, and chest abnormal shadow. Chest computed tomography revealed a nodule with a cavity in the right upper lobe. Endobronchial ultrasonography (EBUS) of the lesion suggested that the lesion was benign. Actinomyces graevenitzii was cultured from the specimen obtained by bronchoscopy using endobronchial ultrasonography with a guide sheath technique and was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA sequencing. The patient was treated with intravenous ampicillin; subsequently, his condition improved. We believe that careful observation of EBUS findings may be useful for the differential diagnosis.
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Affiliation(s)
- Daisuke Himeji
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Sachika Hara
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Takeshi Kawaguchi
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Gen-Ichi Tanaka
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
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Al-Awadhi R, Al-Shaheen A, Al-Juwaiser A, George SS, Sharma P, Kapila K. Prevalence of Infectious Organisms Observed in Cervical Smears Between 1997-2014 at Mubarak Al-Kabeer Hospital, Kuwait. Sultan Qaboos Univ Med J 2018; 18:e324-e328. [PMID: 30607273 PMCID: PMC6307630 DOI: 10.18295/squmj.2018.18.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 01/24/2018] [Accepted: 03/25/2018] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to examine gynaecological infectious agents observed in conventional and modified Papanicolaou cervical smears (CS) at a tertiary care hospital in Kuwait. METHODS This retrospective study analysed 121,443 satisfactory CS samples collected between 1997-2014 at the Mubarak Al-Kabeer Hospital, Kuwait. Conventional CS samples were obtained between 1997-2005, while modified CS were obtained between 2006-2014 following the introduction of ThinPrep® testing (Hologic Corp., Bedford, Massachusetts, USA). All samples were initially screened by cytoscreeners before being analysed by cytopathologists to determine the presence of specific infectious agents. RESULTS Overall, 8,836 (7.28%) of the cervical samples had infectious agents; of these, 62.48% were conventional and 37.52% were modified CS samples. The most frequently observed infectious agents were Candida species (76.05%), Trichomonas vaginalis (9.72%), human papillomavirus (HPV; 9.3%), Actinomyces-like organisms (3.23%), Chlamydia trachomatis (1.27%) and the herpes simplex virus (HSV; 0.43%). There were significantly more cases of Candida species, HPV-associated changes, C. trachomatis, T. vaginalis and Actinomyces-like organisms detected in conventional compared to modified CS samples (P <0.050 each). However, there was no statistically significant difference in the frequency of HSV-associated changes (P = 0.938). The presence of two infectious agents in the same sample was identified in 0.87% of samples. CONCLUSION Among CS samples collected during an 18-year period, Candida species were most frequently detected, followed by T. vaginalis and HPV. The identification of potential infectious agents is a valuable additional benefit of Papanicolaou smear testing.
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Affiliation(s)
- Rana Al-Awadhi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait
| | | | | | - Sara S. George
- Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait
| | - Prem Sharma
- Department of Research & Biostatistics Unit, Faculty of Medicine, Kuwait University, Kuwait
| | - Kusum Kapila
- Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait
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Abstract
RATIONALE Immunoglobulin (Ig)G4-related pseudotumors of the liver are very rare diseases that are difficult to distinguish from malignant tumors. They can be usually improved by steroid therapy. Actinomycosis is a chronic, suppurative, granulomatous infection, for which immune suppression is a predisposing factor. It can also mimic malignant tumors. PATIENT CONCERNS A 67-year-old man presented with mild abdominal discomfort and a 5-kg weight loss for 3 months. Initially, he visited another hospital and was treated with antibiotics under the assumption of a liver abscess. Symptom was not resolved. DIAGNOSES He diagnosed as having an IgG4-related pseudotumor of the right lobe of the liver after liver biopsy. Despite 2 months of steroid therapy, the liver mass was aggravated and invaded the right lung, as observed on follow-up computed tomography scan. INTERVENTIONS We performed en bloc resection of the tumor under the assumption that it was a malignant tumor. OUTCOMES The pathology of the tumor was revealed as actinomycotic colonies and IgG4-positive plasma cells of the liver. He recovered well and was discharged with ursodeoxycholic acid tablet for 14 days. After 3 months, he underwent postoperative follow-up CT and there was no remarkable finding in remnant left hepatic lobe. LESSONS Hepatic actinomycosis and IgG4-related pseudotumors of the liver are both difficult to diagnose. As in our patient, combined diseases are more difficult to diagnose and to determine the optimal treatment. Since immunosuppression therapy of autoimmune diseases can cause and aggravate infection, management must be approached carefully. We can learn that various possibilities must be considered before diagnosing and treating a hepatic mass.
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Affiliation(s)
| | - Hyung Sun Kim
- Pancreatobiliary Cancer Clinic, Department of Surgery
| | | | - Dong Ki Lee
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University, Seoul, Korea
| | - Jin Hong Lim
- Pancreatobiliary Cancer Clinic, Department of Surgery
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Gravito-Soares E, Gravito-Soares M, Souto P, Fraga J, Tomé L. Beyond colonic neoplasia. Acta Gastroenterol Belg 2018; 81:348. [PMID: 30024715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Elisa Gravito-Soares
- Department of Gastroenterology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Marta Gravito-Soares
- Department of Gastroenterology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Paulo Souto
- Department of Gastroenterology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - João Fraga
- Department of Pathology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Luis Tomé
- Department of Gastroenterology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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63
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64
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Abstract
RATIONALE Osteoma with actinomycosis is a very rare disease in the nasal cavity. PATIENT CONCERNS We report a case of a 17-year-old female student who presented with nasal obstruction and rhinorrhea for 6 months. DIAGNOSES The preoperative finding was osteoma covered with yellowish polypoid material. INTERVENTIONS We performed endoscopic sinus surgery, which included excision of the tumor and medication with oral penicillin for 8 weeks. OUTCOMES Postoperative recovery was uneventful. There was no evidence of tumor recurrence during the 1-year period after surgery. CONCLUSION Anaerobic conditions as a result of allergic rhinitis and narrowed nasal cavity because of osteoma can be the cause of formation of actinomycosis. Clinicians should note that osteoma with actinomycosis can be treated with surgical removal of the tumor and short-term antibiotic therapy.
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Affiliation(s)
- Jong Seung Kim
- Department of Otolaryngology-Head and Neck Surgery, Chonbuk National University
- Research Institute of Clinical Medicine of Chonbuk National University—Biomedical Research Institute of Chonbuk National University Hospital
| | - Sang Jae Noh
- Research Institute of Clinical Medicine of Chonbuk National University—Biomedical Research Institute of Chonbuk National University Hospital
- Department of Forensic Science, College of Medicine, Chonbuk National University, Jeonju
| | - Soon Ho Ryu
- Plus I Mi Ko clinic, Suncheon, Chonnam, Korea
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Aleric I, Katalinic D, Vcev A, Brinar M. Pulmonary actinomycosis coexisting with intestinal tuberculosis as a complication of adalimumab treatment for Crohn's disease. Acta Gastroenterol Belg 2017; 80:544-546. [PMID: 29560655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- I Aleric
- Department of Internal Medicine, School of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia
- Department of Pulmonary Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - D Katalinic
- Department of Internal Medicine, School of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia
| | - A Vcev
- Department of Internal Medicine, School of Medicine, J. J. Strossmayer University of Osijek, Osijek, Croatia
| | - M Brinar
- Department of Gastroenterology, University Hospital Centre Zagreb, Zagreb, Croatia
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Mohanty S, Sahu S, Parija S, Praharaj AK. A case of chronic lacrimal canaliculitis: revisiting the role of Actinomyces israelii. Braz J Infect Dis 2017; 21:574-575. [PMID: 28609647 PMCID: PMC9425530 DOI: 10.1016/j.bjid.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 04/07/2017] [Accepted: 05/11/2017] [Indexed: 12/01/2022] Open
Affiliation(s)
- Srujana Mohanty
- All India Institute of Medical Sciences, Department of Microbiology, Bhubaneswar, India.
| | - Subhrajyoti Sahu
- All India Institute of Medical Sciences, Department of Microbiology, Bhubaneswar, India
| | - Sucheta Parija
- All India Institute of Medical Sciences, Department of Ophthalmology, Bhubaneswar, India
| | - Ashok K Praharaj
- All India Institute of Medical Sciences, Department of Microbiology, Bhubaneswar, India
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Boo YL, How KN, Pereira DS, Chin PW, Foong KK, Lim SY. Pulmonary actinomycosis masquerading as lung cancer: A case report. Med J Malaysia 2017; 72:246-247. [PMID: 28889138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pulmonary actinomycosis is a rare yet important and challenging diagnosis to make. It is commonly confused with other lung diseases, such as tuberculosis and bronchogenic carcinoma, leading to delay diagnosis or misdiagnosis. A 49-year-old man presented with a chronic cough, hemoptysis, and pleuritic chest pain. His initial imaging studies including computed tomography (CT) was suggestive of bronchogenic carcinoma. A subsequent CTguided biopsy was consistent with pulmonary actinomycosis and excluded the possibility of bronchogenic carcinoma. He was treated with antibiotic therapy and achieved remission with complete radiological resolution upon follow-up.
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Affiliation(s)
- Y L Boo
- Hospital Sultanah Nora Ismail, Department of Medicine, Batu Pahat, Johor, Malaysia.
| | - K N How
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Medicine, Serdang, Selangor, Malaysia
| | - D S Pereira
- Hospital Enche' Besar Hajjah Khalsom, Department of Medicine, Kluang, Johor, Malaysia
| | - P W Chin
- Hospital Enche' Besar Hajjah Khalsom, Department of Medicine, Kluang, Johor, Malaysia
| | - K K Foong
- Hospital Sultanah Aminah, Department of Medicine, Johor Bahru, Johor, Malaysia
| | - S Y Lim
- Hospital Sultanah Nora Ismail, Department of Medicine, Batu Pahat, Johor, Malaysia
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Grzywa-Celińska A, Emeryk-Maksymiuk J, Szmygin-Milanowska K, Czekajska-Chehab E, Milanowski J. Pulmonary actinomycosis - the great imitator. Ann Agric Environ Med 2017; 25:211-212. [PMID: 29936825 DOI: 10.26444/aaem/75652] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Pulmonary localisation represents only 15% of all cases of actinomycosis. The clinical symptoms and radiological changes of this disease are non-specific and sometimes it can be misdiagnosed, usually as tuberculosis, lung cancer or lung abscess. In the reported case, what might look like the lung cancer, finally turned out to be actinomycosis. The interesting case is presented of lung actinomycosis in a 77-year-old farmer, admitted to the Department of Pneumonology, Oncology and Allegology in Lublin due to a massive haemoptysis. CT scan of the chest showed, apart from other changes, the spicular consolidation in the right lung which aroused oncology vigilance. The diagnostic path, which was a real medical challenge, led to the diagnosis of actinomycosis. The process of diagnosis and consequent treatment, which led to the complete regression of clinical and radiological changes, is presented.
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Affiliation(s)
- Anna Grzywa-Celińska
- Chair and Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Poland.
| | - Justyna Emeryk-Maksymiuk
- Chair of Internal Medicine and Department of Internal Medicine in Nursing, Medical University of Lublin, Poland
| | | | | | - Janusz Milanowski
- Chair and Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Poland
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Polden KE, Jehle H. Actinomycosis of the foot - A South African case. S AFR J SURG 2017; 55:36. [PMID: 28876622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Mycetoma is a chronic infection, characterised by severe disability and discomfort to patients. This condition is common throughout tropical regions of the world. The Indian subcontinent and north-east Africa, especially Sudan, bear the majority of the disease burden. Due to the limited resources and isolation of these areas, the condition is usually misdiagnosed or incorrectly managed. The World Health Organisation listed the condition as a "neglected disease" in 2013. The creation of the Mycetoma Research Centre (MRC) by the University of Khartoum in 1991 has greatly contributed to the current understanding of this disabling condition. We report a case of a 17-year-old boy from Port Elizabeth, South Africa. Uncommon in South Africa, this condition is easily misdiagnosed and mismanaged.
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Affiliation(s)
- K E Polden
- Department of Surgery, Livingstone Hospital, Walter Sisulu University (WSU)
| | - H Jehle
- Department of Surgery, Livingstone Hospital, Walter Sisulu University (WSU)
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Saleem MA, Ul Abideen Z, Kiani IS, Yousaf A, Rasheed A, Shabbir RW. Sporadic actinomycosis of the hip complicated by Central Nervous System infection. J PAK MED ASSOC 2017; 67:637-640. [PMID: 28420932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Actinomycosis is caused by the Gram positive filamentous Actinomyces bacterial species that are normal commensals of the oral cavity. Due to their low virulence, disease is rare in the immune competent patient. Although it may afflict any system in the body, involvement of the musculoskeletal system is uncommon. Here in, we describe the case of a 60 year old lady presenting with low grade fever, left hip pain and drowsiness. She was diagnosed as left hip actinomycosis on Computed tomogram (CT) guided biopsy and histopathological analysis of infiltrative lesions identified on Magnetic Resonance Imaging (MRI). She also had meningitis diagnosed on cerebrospinal fluid analysis which improved with treatment of actinomycosis. Actinomycosis of the hip is rare, and occurs in the presence of described predisposing factors. To the best of our knowledge, this is the first case of sporadic actinomycosis of the hip complicated by meningitis in an immune competent individual.
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Affiliation(s)
| | - Zain Ul Abideen
- Department of Nephrology and Renal Transplant, Shifa International Hospital, Islamabad, Pakistan
| | - Iram Shakir Kiani
- Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan
| | - Anum Yousaf
- Benazir Bhutto Hospital, Rawalpindi, Pakistan
| | - Amna Rasheed
- Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan
| | - Raja Wajid Shabbir
- Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan
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71
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Rosdina Z, Nurul Yaqeen ME, Hanafiah M, Nor Salmah B. Pulmonary actinomycosis masquerading as aspergilloma. Med J Malaysia 2017; 72:147-149. [PMID: 28473686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We report a case of a 34-year-old man who was initially treated as community acquired pneumonia following a three-month-history of productive cough, loss of weight and loss of appetite. However, three months after discharged from the hospital, he presented again with worsening respiratory symptoms and radiological evidence of a lung cavitation with intracavitary lesion resembling an aspergilloma associated with surrounding consolidation. Unfortunately, he remained symptomatic despite on antifungal therapy. The repeat computed-tomography demonstrated persistent cavitating lesion with development of necrotising pneumonia. He underwent lobectomy and the histopathological analysis of the resected specimen however revealed the diagnosis of actinomycosis.
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Affiliation(s)
- Z Rosdina
- Universiti Teknologi MARA, Faculty of Medicine, Respiratory Unit, Selangor, Malaysia.
| | - M E Nurul Yaqeen
- Universiti Teknologi MARA, Faculty of Medicine, Respiratory Unit, Selangor, Malaysia
| | - M Hanafiah
- Universiti Teknologi MARA, Faculty of Medicine, Medical Imaging Unit, Selangor, Malaysia
| | - B Nor Salmah
- Universiti Teknologi MARA, Faculty of Medicine, Pathology Discipline, Selangor, Malaysia
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72
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Kakkos A, Gonne E, Coimbra C, Nervo P, Remacle G, Thille A, Hayette MP, Van Linthout C, Kridelka F, Delbecque K. [Pseudotumoral pelvic actinomycosis : one should think of it]. REVUE MEDICALE DE LIEGE 2017; 72:10-13. [PMID: 28387071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Actinomycosis is a rare chronic disease caused by a group of anaerobic Gram positive bacteria. It may mimic a neoplasia at various anatomical levels. A pelvic localization is exceptional but has an increasing incidence since the use of intrauterine devices. In such cases, pelvic actinomycosis may present as a gynecological or a lower colonic malignancy. For all atypical clinical, with a prominent infectious or inflammatory context, the diagnosis of actinomycosis must be suggested and discussed with the pathologist to whom the biopsy will be submitted. In the absence of a preoperative diagnosis, an inadequately aggressive pelvic surgery might be performed and rendered particularly complex due to the adherent and diffusely inflammatory pattern of the disease. The treatment of choice remains a long-term therapy with antibiotics that leads to a complete clinical and radiological response in the majority of cases. We report the case of a 27-year-old woman with a clinical and radiological diagnosis of rectal carcinoma but with limited preoperative biopsy that revealed a pelvic actinomycosis and allowed a conservative and successful antibacterial treatment.
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Affiliation(s)
- A Kakkos
- Service de Gynécologie- Obstétrique, CHU de Liège, Site Sart Tilman, Belgique
| | - E Gonne
- Service d'Oncologie Médicale, CHU de Liège, Site Sart Tilman, Belgique
| | - C Coimbra
- Service de Chirurgie Abdominale, Sénologique, Endocrine et Transplantation, CHU de Liège, Site Sart Tilman, Belgique
| | - P Nervo
- Service de Gynécologie - Obstétrique, CHU de Liège, Belgique
| | - G Remacle
- Service de Chirurgie Abdominale,Sénologique, Endocrine et Transplantation, CHU de Liège, Site Sart Tilman, Belgique
| | - A Thille
- Service de Radiodiagnostic, CHU de Liège, Site Sart Tilman, Belgique
| | - M P Hayette
- Service de Microbiologie Clinique, CHU de Liège, Belgique
| | - C Van Linthout
- Service de Gynécologie - Obstétrique, CHU de Liège, Belgique
| | - F Kridelka
- Service de Gynécologie - Obstétrique, CHU de Liège, Belgique
| | - K Delbecque
- Service d'Anatomie Pathologique, CHU de Liège, Site Sart Tilman, Belgique
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73
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Broly E, Risse J, Maschino F, Wahl D. Cardiac Tamponade Due to Actinomyces odontolyticus Originating From a Dentigerous Cyst. J Oral Maxillofac Surg 2016; 74:2453-2456. [PMID: 27311847 DOI: 10.1016/j.joms.2016.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/13/2016] [Accepted: 05/13/2016] [Indexed: 11/18/2022]
Abstract
This report describes a rare case of pericardial effusion owing to Actinomyces odontolyticus in a 52-year-old woman that originated from a dentigerous cyst, which developed on the distal aspect of a lower left third molar. The cyst had remained asymptomatic for a long period, with no specific functional complications. This is the first case report of a patient with acute pericarditis in which the same strain of A odontolyticus was detected in an asymptomatic dentigerous cyst and in the pericardial fluid.
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Affiliation(s)
- Elyette Broly
- Resident, Department of Oral Pathology, Oral Medicine and Oral Surgery, Dental Faculty, University Hospital of Nancy, Nancy, France.
| | - Jessie Risse
- Hospital Practioner, Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy, Nancy, France
| | - François Maschino
- Hospital Practitioner, Department of Oral Pathology, Oral Medicine and Oral Surgery, Dental Faculty, University Hospital of Nancy, Nancy, France
| | - Denis Wahl
- University Professor and Hospital Practitioner, Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy, Nancy, France
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74
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Qureshi A. Thoracic Mass in an Immune-Competent Child. J Coll Physicians Surg Pak 2016; 26:548-549. [PMID: 27354003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/27/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Asim Qureshi
- Department of Pathology, Sultan Qaboos University Hospital, Muscat, Oman
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75
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Bonnefond S, Catroux M, Melenotte C, Karkowski L, Rolland L, Trouillier S, Raffray L. Clinical features of actinomycosis: A retrospective, multicenter study of 28 cases of miscellaneous presentations. Medicine (Baltimore) 2016; 95:e3923. [PMID: 27311002 PMCID: PMC4998488 DOI: 10.1097/md.0000000000003923] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Actinomycosis is a rare heterogeneous anaerobic infection with misleading clinical presentations that delay diagnosis. A significant number of misdiagnosed cases have been reported in specific localizations, but studies including various forms of actinomycosis have rarely been published.We performed a multicenter retrospective chart review of laboratory-confirmed actinomycosis cases from January 2000 until January 2014. We described clinical characteristics, diagnostic procedures, differential diagnosis, and management of actinomycosis of clinical significance.Twenty-eight patients were included from 6 hospitals in France. Disease was diagnosed predominately in the abdomen/pelvis (n = 9), orocervicofacial (n = 5), cardiothoracic (n = 5), skeletal (n = 3), hematogenous (n = 3), soft tissue (n = 2), and intracranially (n = 1). Four patients (14%) were immunocompromised. In most cases (92 %), the diagnosis of actinomycosis was not suspected on admission, as clinical features were not specific. Diagnosis was obtained from either microbiology (50%, n = 14) or histopathology (42%, n = 12), or from both methods (7%, n = 2). Surgical biopsy was needed for definite diagnosis in 71% of cases (n = 20). Coinfection was found in 13 patients (46%), among which 3 patients were diagnosed from histologic criteria only. Two-thirds of patients were treated with amoxicillin. Median duration of antibiotics was 120 days (interquartile range 60-180), whereas the median follow-up time was 12 months (interquartile range 5.25-18). Two patients died.This study highlights the distinct and miscellaneous patterns of actinomycosis to prompt accurate diagnosis and earlier treatments, thus improving the outcome. Surgical biopsy should be performed when possible while raising histologist's and microbiologist's awareness of possible actinomycosis to enhance the chance of diagnosis and use specific molecular methods.
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Affiliation(s)
- Simon Bonnefond
- Internal Medicine Unit, Teaching Hospital of La Réunion, France
| | - Mélanie Catroux
- Department of internal Medicine and Infectious Diseases, Teaching Hospital of Poitiers, France
| | - Cléa Melenotte
- Department of Internal Medicine, CHU Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Ludovic Karkowski
- Internal Medicine Unit, French Army Teaching Hospital of Metz, France
| | | | | | - Loic Raffray
- Internal Medicine Unit, Teaching Hospital of La Réunion, France
- Internal Medicine Unit, Teaching Hospital of Bordeaux, France
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Affiliation(s)
- Leonardo Artesi
- Department of Otorhinolaryngology, Azienda Ospedaliera di Legnano, Fornaroli Hospital, Magenta, Italy
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Affiliation(s)
- Chung-Ching Hung
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan, The Republic of China
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78
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Velenciuc N, Velenciuc I, Makkai Popa S, Roată C, Ferariu D, Luncă S. PELVIC ACTINOMYCOSIS MIMICKING A LOCALLY ADVANCED PELVIC MALIGNANCY--CASE REPORT. Rev Med Chir Soc Med Nat Iasi 2016; 120:393-399. [PMID: 27483724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We present the case of a former user of an intrauterine contraceptive device (IUD) for 10 years, diagnosed with a bulky, fixed pelvic tumor involving the internal genital organs and the recto sigmoid, causing luminal narrowing of the rectum, interpreted as locally advanced pelvic malignancy, probably of genital origin. Intraoperatively, a high index of suspicion made us collect a sample from the fibrous wall of the tumor mass, large Actinomyces colonies were thus identified. Surgery consisted in debridement, removal of a small amount of pus and appendectomy, thus avoiding a mutilating and useless surgery. Specific antibiotic therapy was administered for 3 months, with favorable postoperative and long-term outcomes. Pelvic actinomycosis should always be considered in the differential diagnosis of pelvic tumors in women using an IUD. The association of long-term antibiotic treatment is essential to eradicate the infection and prevent relapses.
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79
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Lyttle B, Johnson JV. Chronic Actinomyces Infection Caused by Retained Cervical Cerclage: A Case Report. J Reprod Med 2016; 61:179-181. [PMID: 27172644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Historically, Actinomyces infection has been associated primarily with the intrauterine device. Recently, case reports associating Actinomyces with other implants have been described, including nonwoven polypropylene mesh used for urethral slings and Mersilene cerclage placements. However, there are no reported cases of chronic Actinomyces infections associated with retained Mersilene cerclage. CASE A 51-year-old woman, gravida 3, para 3, presented with a 10-year history of vaginal discharge and Actinomyces identified on endometrial biopsy. After failing medical treatment and undergoing a hysterectomy, the patient was found to have a retained Mersilene cerclage. CONCLUSION This is the first case to report persistent Actinomyces infection with a retained Mersilene cerclage. No current recommendations exist for assessing full removal of cerclage. Clinicians should have a high suspicion of Actinomyces infection in a patient who presents with persistent vaginal discharge and history of cerclage placement.
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80
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Suwantarat N, Romagnoli M, Carroll KC. Photo Quiz: Isolation of an Unusual Gram-Positive Coccus from a Positive Blood Culture in a Patient with Pneumonia. Actinomyces radicidentis Bacteremia. J Clin Microbiol 2016; 54:1, 247. [PMID: 26719581 PMCID: PMC4702744 DOI: 10.1128/jcm.masthead.54-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
MESH Headings
- Actinomyces/classification
- Actinomyces/isolation & purification
- Actinomycosis/diagnosis
- Actinomycosis/microbiology
- Actinomycosis/pathology
- Animals
- Bacteremia/diagnosis
- Bacteremia/microbiology
- Bacteriological Techniques
- DNA, Bacterial/chemistry
- DNA, Bacterial/genetics
- DNA, Ribosomal/chemistry
- DNA, Ribosomal/genetics
- Humans
- Male
- Microscopy
- Middle Aged
- Pneumonia, Bacterial/complications
- Pneumonia, Bacterial/diagnosis
- Pneumonia, Bacterial/microbiology
- RNA, Ribosomal, 16S/genetics
- Sequence Analysis, DNA
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Affiliation(s)
- Nuntra Suwantarat
- Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mark Romagnoli
- Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Karen C Carroll
- Division of Medical Microbiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Microbiology Laboratory, Johns Hopkins Hospital, Baltimore, Maryland, USA
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81
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Ishida H, Murasawa M, Yoshizawa M, Hoshino T, Hanawa T, Kuwabara M. [Postoperatively Diagnosed Pulmonary Actinomycosis;Report of Three Cases]. Kyobu Geka 2015; 68:867-870. [PMID: 26329633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Three cases of pulmonary actinomycosis have been postoperatively diagnosed in our hospital in the past 3 years. All the cases were preoperatively difficult to differentiate from lung cancer, and all were diagnosed in men. One of the patients was diagnosed on the basis of clinical symptoms, while the other 2 patients were diagnosed during the treatment and follow-up of other diseases. On radiological examination, 2 patients showed mass-like shadows, and the 3rd showed a cavitary lesion; fluorodeoxyglucose (FDG) -positron emission tomography showed high FDG accumulation in all the patients. One of the patients was pathologically suspected with lung cancer on transbronchial lung biopsy. Right upper lobectomy was performed in 2 patients, and right lower lobectomy in 1. One of the patients who underwent right upper lobectomy, also received chest wall resection because of the perioperative finding of chest wall invasion of lung cancer. Clinically, all the cases were preoperatively diagnosed as lung cancer.
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Affiliation(s)
- Hisao Ishida
- Department of General Thoracic Surgery, The Second Okamoto General Hospital, Uji, Japan
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Abstract
INTRODUCTION Acne inversa (AI) is a chronic and recurrent inflammatory skin disease. It occurs in intertriginous areas of the skin and causes pain, drainage, malodor and scar formation. While supposedly caused by an autoimmune reaction, bacterial superinfection is a secondary event in the disease process. METHODS A unique case of a 43-year-old male patient suffering from a recurring AI lesion in the left axilla was retrospectively analysed. RESULTS A swab revealed Actinomyces neuii as the only agent growing in the lesion. The patient was then treated with Amoxicillin/Clavulanic Acid 3 × 1 g until he was cleared for surgical excision. The intraoperative swab was negative for A. neuii. Antibiotics were prescribed for another 4 weeks and the patient has remained relapse free for more than 12 months now. CONCLUSION Primary cutaneous Actinomycosis is a rare entity and the combination of AI and Actinomycosis has never been reported before. Failure to detect superinfections of AI lesions with slow-growing pathogens like Actinomyces spp. might contribute to high recurrence rates after immunosuppressive therapy of AI. The present case underlines the potentially multifactorial pathogenesis of the disease and the importance of considering and treating potential infections before initiating immunosuppressive regimens for AI patients.
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Affiliation(s)
- Jakob Nedomansky
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Doris Weiss
- Division of Immunology, Department of Dermatology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria
| | - Birgit Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Stefanie Nickl
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Christoph Steininger
- Division of Infectious Diseases, Department of Medicine 1, Medical University of Vienna, Vienna, Austria.
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83
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Gupta P, Dogra V, Goel N, Chowdhary A, Prasad R, Gaur SN. An Unusual Cause of a Pulmonary Mass: Actinomycosis. Indian J Chest Dis Allied Sci 2015; 57:177-179. [PMID: 26749917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We present the case of a 62-year-old male with chronic obstructive pulmonary disease and poorly controlled diabetes mellitus who presented with haemoptysis. A radiograph of the chest showed a right lower parahilar opacity which on the contrast enhanced computed tomography was seen to be an irregular, spiculated mass localised to the middle lobe. Considering malignancy as the most probable diagnosis, a bronchoscopic endobronchial biopsy was performed which surprisingly established pulmonary actinomycosis as the diagnosis. The patient was successfully managed with amoxicillin and clavulanic acid and glycaemic control.
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84
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Jäckel K, Braschler T, Jochum W, Hülder T, Knechtle B. [How is agonizing leg pain associated with an intrauterine device?]. Praxis (Bern 1994) 2015; 104:517-522. [PMID: 26098054 DOI: 10.1024/1661-8157/a002002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report on a typical clinical course of pelvic actinomycosis: initial uncharacteristic discomfort develops into a systemic illness associated with a pelvic mass, which progresses so fast that along with the systemic infection further symptoms can be reduced to its growth rate--tiredness, abdominal pain, micturition deficiency, and leg pain. Distinction between malignancy and pelvic actinomycosis could be made only intraoperative. After hysterectomy and with antibiotics the patient recovered quickly.
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85
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Kottam A, Kaur R, Bhandare D, Zmily H, Bheemreddy S, Brar H, Herawi M, Afonso L. Actinomycotic endocarditis of the eustachian valve: a rare case and a review of the literature. Tex Heart Inst J 2015; 42:44-9. [PMID: 25873798 PMCID: PMC4378043 DOI: 10.14503/thij-13-3517] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Eustachian valve endocarditis caused by Actinomyces species is extremely rare. A literature review revealed only one reported case-caused by Actinomyces israelii in an intravenous drug abuser. Our patient, a 30-year-old woman who at first appeared to be in good health, presented with fever, a large mobile mass on the eustachian valve, and extensive intra-abdominal and pelvic masses that looked malignant. Histopathologic examination of tissue found in association with an intrauterine contraceptive device revealed filamentous, branching microorganisms consistent with Actinomyces turicensis. This patient was treated successfully with antibiotic agents. In addition to presenting a new case of a rare condition, we discuss cardiac actinomycotic infections in general and eustachian valve endocarditis in particular: its predisposing factors, clinical course, sequelae, and our approaches to its management.
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Affiliation(s)
- Anupama Kottam
- Address for reprints: Anupama Kottam, MD, Division of Cardiology, 4 Hudson, Harper University Hospital, Wayne State University, 3990 John R St., Detroit, MI 48201, E-mail:
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87
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Mahfoudhi M, Khamassi K. Sinusite ethmoïdo-maxillaire chronique chez un diabétique: penser à l’actinomycose. Pan Afr Med J 2015; 20:450. [PMID: 26309481 PMCID: PMC4537913 DOI: 10.11604/pamj.2015.20.450.6854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 04/29/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Madiha Mahfoudhi
- Service de Médecine Interne A, Hôpital Charles Nicolle, Tunis, Tunisie
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88
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Roopesh Kumar VR, Madhugiri VS, Gundamaneni SK, Verma SK. Actinomycotic osteomyelitis of the cranial vault presenting with headache: an unusual presentation. BMJ Case Rep 2014; 2014:bcr2013202501. [PMID: 25422325 PMCID: PMC4244526 DOI: 10.1136/bcr-2013-202501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2014] [Indexed: 11/04/2022] Open
Abstract
A case of left parietal calvarial actinomycotic osteomyelitis in a young woman is described. She had no predisposing illnesses. She had delivered a live child at term and presented in the puerperal period. No extracranial focus of infection was identified. She responded well to a combination of surgery and medical therapy and had an excellent outcome. The authors emphasise the importance of establishing a histopathological diagnosis since radiological signs are non-specific and unreliable.
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Affiliation(s)
- V R Roopesh Kumar
- Department of Neurosurgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER),Pondicherry, India
| | - Venkatesh S Madhugiri
- Department of Neurosurgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER),Pondicherry, India
| | - Sudheer Kumar Gundamaneni
- Department of Neurosurgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER),Pondicherry, India
| | - Surendra Kumar Verma
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
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Yang XX, Lin JM, Xu KJ, Wang SQ, Luo TT, Geng XX, Huang RG, Jiang N. Hepatic actinomycosis: Report of one case and analysis of 32 previously reported cases. World J Gastroenterol 2014; 20:16372-16376. [PMID: 25473199 PMCID: PMC4239533 DOI: 10.3748/wjg.v20.i43.16372] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 07/05/2014] [Accepted: 08/28/2014] [Indexed: 02/06/2023] Open
Abstract
Hepatic actinomycosis is rare, with few published cases. There are no characteristic clinical manifestations, and computed tomography (CT) shows mainly low-density images, making clinical diagnosis difficult, and leading to frequent misdiagnosis as primary liver cancer, metastatic liver cancer or liver abscess. Diagnosis normally requires examination of both the aetiology and pathology. This article reports one male patient aged 55 who was hospitalized because of repeated upper abdominal pain for more than 2 mo. He exhibited no chills, fever or yellow staining of the skin and sclera, and examination revealed no positive signs. The routine blood results were: haemoglobin 110 g/L, normal numbers of leukocytes and neutral leukocytes, serum albumin 32 g/L, negative serum hepatitis B markers and hepatitis C antibodies, normal tumour markers (alpha-fetoprotein and carcinoembryonic antigen). An abdominal CT scan revealed an 11.2 cm × 5.8 cm × 7.4 cm mass with an unclear edge in the left liver lobe. The patient was diagnosed as having primary liver cancer, and left lobe resection was performed. The postoperative pathological examination found multifocal actinomycetes in the hepatic parenchyma, which was accompanied by chronic suppurative inflammation. A focal abscess had formed, and large doses of sodium penicillin were administered postoperatively as anti-infective therapy. This article also reviews 32 cases reported in the English literature, with the aim of determining the clinical features and treatment characteristics of this disease, and providing a reference for its diagnosis and treatment.
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90
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Pierre I, Zarrouk V, Noussair L, Molina JM, Fantin B. Invasive actinomycosis: surrogate marker of a poor prognosis in immunocompromised patients. Int J Infect Dis 2014; 29:74-9. [PMID: 25449239 DOI: 10.1016/j.ijid.2014.06.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 06/12/2014] [Accepted: 06/13/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Actinomycosis is a rare disease favored by disruption of the mucosal barrier. In order to investigate the impact of immunosuppression on outcome we analyzed the most severe cases observed in patients hospitalized in three tertiary care centers. METHODS We reviewed all cases of proven invasive actinomycosis occurring over a 12-year period (1997 to 2009) in three teaching hospitals in the Paris area. RESULTS Thirty-three patients (16 male) were identified as having an invasive actinomycosis requiring hospitalization. The diagnosis was made by microbiological identification in 26 patients, pathological examination in eight patients, and by both methods in one. Twenty patients (61%) were immunocompromised. Actinomycosis localization was abdominal or pelvic in 17 patients, thoracic in 11, cervicofacial in three, and neurological in two. Twenty patients (61%) underwent surgery. All strains were susceptible to amoxicillin. All patients were treated with a beta-lactam antibiotic, for a median length of 82 days. Twenty-eight patients (85%) were considered as cured. Overall mortality at hospital discharge was 21% (7/33). Mortality was higher in immunocompromised patients (7/20; 21%) compared to non-immunocompromised patients (0/13) (p=0.027). However, six of seven deaths were directly related to the underlying disease. CONCLUSIONS Actinomycosis is a cause of severe infection in immunocompromised patients and a surrogate marker of a poor prognosis in this specific population.
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Affiliation(s)
- Isabelle Pierre
- Service de Médecine Interne, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, 100 boulevard du général Leclerc, 92110 Clichy, France
| | - Virginie Zarrouk
- Service de Médecine Interne, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, 100 boulevard du général Leclerc, 92110 Clichy, France
| | - Latifa Noussair
- Service de Microbiologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France
| | - Jean-Michel Molina
- Service de Maladies Infectieuses et Tropicales, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, Paris, France
| | - Bruno Fantin
- Service de Médecine Interne, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, 100 boulevard du général Leclerc, 92110 Clichy, France; Université Paris-Diderot, Sorbonne Paris Cité, Paris, France.
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91
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Serghini M, Labidi A, Dabbabi H, Rehaiem R, Daghfous A, Azzouz H, Chelly I, Azeiz O, Filali A. [Abdominal pseudotumoral actinomycosis. A case report]. Tunis Med 2014; 92:647-648. [PMID: 25860684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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92
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Lipowska AM, Johns MM. Actinomycosis of the pharynx. Ear Nose Throat J 2014; 93:404-408. [PMID: 25255347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Few cases of pharyngeal actinomycosis have been documented in the literature. We describe the case of a 67-year-old white man who presented with symptoms of dysphagia. Laryngoscopy revealed a pedunculated mass in the left posterior pharyngeal wall; an excisional biopsy confirmed the diagnosis. Postoperatively, the patient underwent 10 weeks of intravenous penicillin therapy followed by 4 months of oral antibiotics, and his condition resolved. We discuss the diagnosis, management, and complications of this rare infection.
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Affiliation(s)
- Anna M Lipowska
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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93
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Seghers CB, Stappaerts I. Thoracopulmonary actinomycosis, a case report of a 42-year-old man with coughing and a bump in his right axilla. Acta Clin Belg 2014; 69:287-9. [PMID: 24916749 DOI: 10.1179/2295333714y.0000000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The diagnosis of thoracopulmonary actinomycosis is challenging because it is a rare disease, symptoms are aspecific and can mimic a lot of other lung pathologies. Especially the differential diagnosis with pulmonary tuberculosis is difficult because clinical symptoms are often very similar. We present a case of thoracopulmonary abcedating actinomycosis in a young immunocompetent man with no predisposing illness. He was initially treated for pulmonary tuberculosis. He showed good response to IV penicillin, which was later switched to oral amoxicillin when he went home.
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94
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Aoki H, Nagase A, Honmou S, Watanabe K, Maeda A. [Pulmonary actinomycosis that was difficult to make an accurate diagnosis]. Kyobu Geka 2014; 67:553-556. [PMID: 25137325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A 35-year-old man was referred to our hospital, because of recurrent pneumonia. His chest X-ray film and computed tomography showed mass-like consolidation with a cavity in the right upper lobe. He underwent a bronchoscopic examination, but no diagnosis was established. Therefore a surgical biopsy was performed, but the pathological findings revealed that it was only an inflammatory change without any malignant component. For a while, antibiotic and the steroid treatment was continued resulting in the aggravation of clinical findings. Finally, an upper lobe excision was performed for the complete excision of the lesion. As a result of pathology, pulmonary actinomycosis was diagnosed.
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Affiliation(s)
- Hiroyuki Aoki
- Department of Surgery, Asahikawa Medical Center, Asahikawa, Japan
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95
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Vidaković B, Macan D, Perić B, Spomenka M. Actinomycosis of the cheek. SRP ARK CELOK LEK 2014; 142:472-475. [PMID: 25233694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Actinomycosis is an uncommon chronic granulomatous infection first described by Bollinger in 1 877.The infection is caused by actinomyces species and it is characterized by slow contiguous spread and suppurative inflammation, formation of multiple abscesses and sinus tracts with possible drainage of "sulfur granules". CASE OUTLINE We report an unusual case of actinomycosis of the cheek that occurred 6 years after buccal odontogenic abscess. A 56-year-old male was referred to the Department of Oral Surgery because of a painless swelling of the left cheek, which initiated three weeks prior to the referral. The diagnosis of actinomycosis was confirmed by histopathologic examination. In accordance with the diagnosis oral penicillin was prescribed for four months with complete resolution. CONCLUSION This case of actinomycosis is presented as a rarity. For proper diagnosis, careful examination and a high degree of clinical suspicion are necessary.
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96
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Petrie BA, Schwartz SI, Saltmarsh GF. Intra-abdominal actinomycosis in association with sigmoid diverticulitis. Am Surg 2014; 80:E157-E159. [PMID: 24887777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Beverley A Petrie
- Department of Surgery, Section of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, California, USA
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97
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Abstract
Abdominal actinomycosis is a rare chronic infectious disease, which may mimic abdominal cancer, inflammatory bowel disease or diverticulitis. We report the case of a 46-year-old women with a large bowel obstruction caused by extensive abdominal actinomycosis. Colon contrast examination revealed a stenosis in the sigmoid colon, while abdominal ultrasound showed a stenosis of the left ureter with left hydronephrosis. Preoperative presumptive diagnosis was a carcinoma of the sigmoid colon. She required emergency surgery, which involved both resection and colostomy. As in most cases reported in the literature, diagnosis was made postoperatively. Pathological examination following the sigmoid colon resection surprisingly revealed an actinomycosis. This case illustrates that consideration of actinomycosis in women with bowel obstruction and prolonged use of an intrauterine device could help to improve the preoperative diagnosis of this rare disease.
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Affiliation(s)
- F Hohenbleicher
- Chirurgische Klinik und Poliklinik Innenstadt, Klinikum der Ludwig-Maximilians-Universität, Nussbaumstrasse 20, 80336 München
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98
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Dumitru E, Dumitru IM, Popescu R, Resul G, Bulbuc I, Rugina S. Simultaneous occurrence of two rare diseases: actinomycosis and melanoma of the rectum. J Gastrointestin Liver Dis 2014; 23:95-98. [PMID: 24689104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The simultaneous occurrence of two rare conditions in a single patient is uncommon. We report the case of a patient with rectal actinomycosis covering an anorectal melanoma (both infrequent conditions), the last one being later recognized, only after surgical excision. We underline here the role of thinking "outside the box" when an unusual situation is experienced.
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99
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Ng N, Ng G, Davis BR, Meier DE. Actinomyces appendicitis: diagnostic dilemma--malignancy or infection? Am Surg 2014; 80:E33-E35. [PMID: 24401512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Nathaniel Ng
- Department of Surgery, Texas Tech University Health Sciences Center at El Paso, El Paso, Texas, USA
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100
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Denisova OA, Cherniavskaia GM, Beloborodova ÉI, Topol'nitskiĭ EB, Iakimenko IV, Chernogoriuk GÉ, Beloborodova EV, Strezh IA, Vil'danova LR. [A case of thoracic actinomycosis]. Klin Med (Mosk) 2014; 92:59-61. [PMID: 25265662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A case of thoracic actinomycosis manifest as round shadow in the lung is described. Diagnosis was based on the presence of actinomycetes in a transthoracic lung biopsy sample. Treatment for 3 months resulted in recovery. No relapse was documented during 1 year follow-up period.
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