1
|
Maghsoudi MR, Azizmanesh M, Rozveh JK, Chaghamirzayi P. Abdominal actinomycosis presented as acute abdomen with intra-abdominal multiple tumors: A case report. Int J Surg Case Rep 2024; 122:110113. [PMID: 39096654 PMCID: PMC11345931 DOI: 10.1016/j.ijscr.2024.110113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 07/25/2024] [Accepted: 07/30/2024] [Indexed: 08/05/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Actinomycosis, a rare infection caused by Actinomyces spp., typically presents as a chronic condition affecting various regions, particularly the cervicofacial, thoracic, and abdominal areas. Its diagnosis is often difficult due to symptom overlap with malignancies and other infections. This report details a case of abdominal actinomycosis mimicking multiple intra-abdominal tumors, complicating diagnosis and treatment. CASE PRESENTATION A 67-year-old male with uncontrolled type 2 diabetes presented with generalized abdominal pain, nausea, vomiting, constipation, and significant weight loss. Physical examination revealed distention and severe abdominal tenderness. Laboratory tests showed leukocytosis and anemia. Diagnostic laparotomy revealed multiple intra-abdominal tumors. Histopathology confirmed actinomycosis without malignancy or tuberculosis. Intravenous amoxicillin was started; however, the patient discharged himself against medical advice after two days due to personal reasons unrelated to his treatment plan. He returned three months later with persistent abdominal pain and additional hepatic lesions. Extended antibiotic therapy for 12 months led to the resolution of symptoms during follow-up. CLINICAL DISCUSSION Abdominal actinomycosis is rare and often associated with conditions like diabetes. This case underscores the infection's potential to mimic malignancy and highlights the need for considering actinomycosis in differential diagnoses of acute abdomen, especially in immunocompromised patients. The patient's uncontrolled diabetes likely contributed to the infection's development and spread. CONCLUSION Abdominal actinomycosis can present acutely, mimicking neoplastic diseases with multiple intra-abdominal masses. Early recognition and prolonged antibiotic therapy are essential to prevent systemic spread, especially in immunocompromised individuals. Clinicians should consider actinomycosis in patients with poorly controlled diabetes and abdominal symptoms.
Collapse
Affiliation(s)
| | - Mohammad Azizmanesh
- Clinical research development unit of Shahid Madani Hospital, Alborz University of Medical Science, Karaj, Iran
| | - Javad Karimi Rozveh
- Clinical research development unit of Shahid Madani Hospital, Alborz University of Medical Science, Karaj, Iran
| | - Pouria Chaghamirzayi
- Clinical research development unit of Shahid Madani Hospital, Alborz University of Medical Science, Karaj, Iran.
| |
Collapse
|
2
|
Abera MT, Dumessa KA, Robele TJ, Tefera TG, Woldeyohannes AM. Dot-in-circle sign in cervical actinomycotic mycetoma: An extremely rare case report. Radiol Case Rep 2024; 19:2160-2167. [PMID: 38515773 PMCID: PMC10950569 DOI: 10.1016/j.radcr.2024.02.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/22/2024] [Indexed: 03/23/2024] Open
Abstract
Actinomycosis is an unusual, chronic granulomatous infection caused by Actinomycetes spp. The organism also causes mycetoma, a neglected tropical disease in endemic regions. We present a very uncommon case of extensive actinomycosis of the soft tissues in the neck with perivertebral extension that showed the dot-in-circle sign on magnetic resonance imaging. A 29-year-old male patient presented with progressively enlarging hard posterior neck swelling of 4 years duration. Subsequently, magnetic resonance imaging showed the dot-in-circle sign in an avidly enhancing infiltrative lesion with extensive involvement of the neck and perivertebral soft tissue. The pathologic examination was in line with actinomycosis. The patient responded to high doses of combination parenteral and oral antibiotics.
Collapse
Affiliation(s)
- Michael T. Abera
- Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia
| | - Kebron A. Dumessa
- Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia
| | - Taye J. Robele
- MCM Comprehensive Specialized Hospital, Department of Pathology, Addis Ababa, Ethiopia
| | - Tesfaye G. Tefera
- Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia
| | - Abebe M. Woldeyohannes
- Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia
| |
Collapse
|
3
|
Krisko AJ, Van Sickels JE. Delayed Presentation of Actinomycosis Following Orthognathic Surgery: An Old Nemesis and a Difficult Diagnosis: Case Presentation and Review of the Literature. Craniomaxillofac Trauma Reconstr 2024; 17:18-23. [PMID: 38371221 PMCID: PMC10874200 DOI: 10.1177/19433875231155986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Study Design Review of the literature with report of Case. Objective To review the presentation of Actinomycosis specifically as it occurs with mandibular osteotomies. Methods A review of the literature and report of an additional case. Results While minor infections secondary to local factors are usually seen 2-3 weeks after surgery, late infections are rare. Host factors may play a role. When actinomycosis is diagnosed, long-term antibiotics are necessary. Conclusions Actinomycosis is very rare following orthognathic surgery. It usually occurs in the mandible and following a sagittal split. Time of presentation for actinomycosis can vary from 6 weeks to 4 months as in our case. Infections occurring this late after surgery should be treated with suspicion of actinomycosis obtaining both cultures and tissue biopsies. Treatment involves an incision and drainage and long-term antibiotics.
Collapse
Affiliation(s)
- Alexander J. Krisko
- Chief Resident Oral and Maxillofacial Surgery, University of Kentucky, Lexington, KY, USA
| | - Joseph E. Van Sickels
- Chief Resident Oral and Maxillofacial Surgery, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
4
|
Paterson GE, Dickens FJ, Hurdman JA, Pirzada OM. Pericardial actinomycosis. BMJ Case Rep 2024; 17:e257733. [PMID: 38195185 PMCID: PMC10806904 DOI: 10.1136/bcr-2023-257733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
A man in his 50s, with a history of night sweats and weight loss, presented acutely with dyspnoea and chest pain. Imaging revealed right middle lobe consolidation and a large pericardial effusion. The diagnosis of actinomycosis was made using endobronchial ultrasound-guided sampling from the pericardial effusion. An orthopantomogram demonstrated that the source was a large cavity in the left lower wisdom tooth. This tooth was extracted before the completion of his antibiotic course, and the patient made a full recovery. Cardiac actinomycosis is rare, and there are few case reports describing endobronchial ultrasound-guided sampling of pericardial fluid.
Collapse
Affiliation(s)
- Georgia E Paterson
- Academic Department of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Felicity J Dickens
- Academic Department of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Judith A Hurdman
- Academic Department of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Omar M Pirzada
- Academic Department of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| |
Collapse
|
5
|
Wasuwanich P, Szymkiewicz D, Kumari J, Vanegas Acosta D. Cervical Facial Actinomycosis Complicated by Bacteremia After 30 Years of Dental Neglect: Successful Treatment With Ceftriaxone and Metronidazole. Cureus 2024; 16:e51734. [PMID: 38318602 PMCID: PMC10839822 DOI: 10.7759/cureus.51734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 02/07/2024] Open
Abstract
Actinomycosis is an uncommon bacterial infection, caused by the Actinomyces species, and it most commonly presents as cervicofacial actinomycosis. The most common risk factors for actinomycosis are poor dental hygiene, oral surgery, maxillofacial trauma, local tissue inflammation, and diabetes. We discuss a case of a male patient in his 50s with 30 years of poor dental hygiene, complicated by tobacco use, who presented with septic shock and was found to have cervicofacial actinomycosis and bacteremia. The treatment of severe actinomycosis often involves prolonged penicillin-based antibiotic therapy. This is the first case in the literature to describe the successful treatment of cervicofacial actinomycosis and bacteremia with intravenous cefepime (later narrowed to ceftriaxone) and oral metronidazole.
Collapse
Affiliation(s)
- Paul Wasuwanich
- College of Medicine, University of Florida College of Medicine, Gainesville, USA
| | | | - Jaya Kumari
- Internal Medicine, Mehran Medical Centre, Karachi, PAK
| | | |
Collapse
|
6
|
Del Fabro G, Volpi S, Fumarola B, Migliorati M, Bertelli D, Signorini L, Matteelli A, Meschiari M. Actinomyces spp. Prosthetic Vascular Graft Infection (PVGI): A Multicenter Case-Series and Narrative Review of the Literature. Microorganisms 2023; 11:2931. [PMID: 38138076 PMCID: PMC10745418 DOI: 10.3390/microorganisms11122931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/26/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Actinomycosis represents a challenging and under-reported complication of vascular surgery. Optimal management of Actinomyces spp. prosthetic vascular graft infection (PVGI) is highly uncertain because of the paucity of reports on this disease. METHODS We conducted a retrospective case-series of Actinomyces-PVGI that occurred in the last five years in two major university hospitals in northern Italy. We searched for previously published cases in the scientific literature. RESULTS We report five original cases of Actinomyces spp. prosthetic vascular graft infection following aortic aneurysm repair. Our literature review retrieved eight similar cases. Most patients were immunocompetent males. Most infections were polymicrobial (11/13 cases), with a prevalence of A. odontolyticus involvement (3/13 cases were associated with. Salmonella spp. infection). All cases had a late presentation (≥4 months from graft placement), with 61% associated with an aorto-enteric fistula. All patients received antibiotic therapy, but the duration was highly heterogeneous (from two weeks to life-long antibiotics). The patients without surgical revision experienced septic recurrences (2/13), permanent dysfunction (1/13), or a fatal outcome (2/13), while of the remainder who underwent vascular graft explant, six recovered completely and one developed a periprosthetic abscess. In two cases follow-up was not available. CONCLUSIONS This case-series aims to raise the diagnostic suspicion and to describe the current management of Actinomyces-PVGIs. We highlight a high heterogeneity in antibiotic duration, choice of the antibiotic regimen, and surgical management. Higher reporting rate is advisable to produce better evidence and optimize management of this rare complication of vascular surgery.
Collapse
Affiliation(s)
- Giovanni Del Fabro
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Sara Volpi
- Clinic of Infectious Diseases, University Hospital of Modena, 41124 Modena, Italy
| | - Benedetta Fumarola
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Manuela Migliorati
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Davide Bertelli
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Liana Signorini
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Alberto Matteelli
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Marianna Meschiari
- Clinic of Infectious Diseases, University Hospital of Modena, 41124 Modena, Italy
| |
Collapse
|
7
|
Tarzamni MK, Aminzadeh Ghavifekr H, Zeynalkhani H, Shirmohamadi M, Eghbali E, Jafarizadeh A, Ghareghoran SS, Hashemizadeh SE, Falahatian M. Xanthogranulomatous cholecystitis in a patient with ulcerative colitis and primary sclerosing cholangitis: A case report. Radiol Case Rep 2023; 18:3513-3521. [PMID: 37547791 PMCID: PMC10403711 DOI: 10.1016/j.radcr.2023.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023] Open
Abstract
Chronic gallbladder disease due to xanthogranulomatous cholecystitis is uncommon, and its symptoms are generally vague. While there is no firm evidence to link xanthogranulomatous cholecystitis to primary sclerosing cholangitis or ulcerative colitis. The patient is a 41-year-old male with a history of ulcerative colitis, primary sclerosing cholangitis, and biliary stenting who complained of symptoms of anorexia, jaundice, and pruritus. In the initial ultrasound exam, there was evidence of intrahepatic and extra-hepatic bile duct dilation along with a significant and mass-like circumferential thickening of the gallbladder wall. Magnetic resonance cholangiopancreatography was performed for further evaluation, which indicated increased gallbladder wall thickness, containing multiple T2 hyper-signal nodules while the mucosal layer was intact. There was also a filling defect in the common bile duct's distal portion. These findings matched a xanthogranulomatous cholecystitis diagnosis and a possibly malignant lesion in the distal of the common bile duct. The patient ultimately had a cholecystectomy, and pathology findings confirmed the diagnosis of xanthogranulomatous cholecystitis. Biopsy specimens obtained from the distal of the common bile duct lesion were microscopically identified as intramucosal adenocarcinoma. In patients with a history of primary sclerosing cholangitis who present with nonspecific symptoms suggesting chronic gallbladder disease and radiologic evidence of circumferential gallbladder wall thickening containing intramural nodules and intact mucosa, xanthogranulomatous cholecystitis should be kept in mind.
Collapse
Affiliation(s)
- Mohammad Kazem Tarzamni
- Department of Radiology, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Homa Aminzadeh Ghavifekr
- Research Center for Evidence‑Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadise Zeynalkhani
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Shirmohamadi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Eghbali
- Department of Radiology, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Jafarizadeh
- Research Center for Evidence‑Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Seyedeh Elnaz Hashemizadeh
- Department of Surgical and Clinical Pathology, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masih Falahatian
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
8
|
Meena DS, Kumar D, Sharma M, Malik M, Ravindra A, Santhanam N, Bohra GK, Garg MK. The epidemiology, clinical presentation and treatment outcomes in CNS actinomycosis: a systematic review of reported cases. Orphanet J Rare Dis 2023; 18:133. [PMID: 37269006 DOI: 10.1186/s13023-023-02744-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND CNS actinomycosis is a rare chronic suppurative infection with non-specific clinical features. Diagnosis is difficult due to its similarity to malignancy, nocardiosis and other granulomatous diseases. This systematic review aimed to evaluate the epidemiology, clinical characteristics, diagnostic modalities and treatment outcomes in CNS actinomycosis. METHODS The major electronic databases (PubMed, Google Scholar, and Scopus) were searched for the literature review by using distinct keywords: "CNS" or "intracranial" or "brain abscess" or "meningitis" OR "spinal" OR "epidural abscess" and "actinomycosis." All cases with CNS actinomycosis reported between January 1988 to March 2022 were included. RESULTS A total of 118 cases of CNS disease were included in the final analysis. The mean age of patients was 44 years, and a significant proportion was male (57%). Actinomycosis israelii was the most prevalent species (41.5%), followed by Actinomyces meyeri (22.6%). Disseminated disease was found in 19.5% of cases. Most commonly involved extra-CNS organs are lung (10.2%) and abdomen (5.1%). Brain abscess (55%) followed by leptomeningeal enhancement (22%) were the most common neuroimaging findings. Culture positivity was found in nearly half of the cases (53.4%). The overall case-fatality rate was 11%. Neurological sequelae were present in 22% of the patients. On multivariate analysis, patients who underwent surgery with antimicrobials had better survival (adjusted OR 0.14, 95% CI 0.04-0.28, p value 0.039) compared to those treated with antimicrobials alone. CONCLUSION CNS actinomycosis carries significant morbidity and mortality despite its indolent nature. Early aggressive surgery, along with prolonged antimicrobial treatment is vital to improve outcomes.
Collapse
Affiliation(s)
- Durga Shankar Meena
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Deepak Kumar
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India.
| | - Mukesh Sharma
- Department of Microbiology, Dr. S.N. Medical College, Jodhpur, India
| | - Manika Malik
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Akshatha Ravindra
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - N Santhanam
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Gopal Krishana Bohra
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Mahendra Kumar Garg
- Department of Internal Medicine (Infectious Diseases), All India Institute of Medical Sciences, Jodhpur, 342005, India
| |
Collapse
|
9
|
Lévay K, Daradics N, Horváth T, Kovács T, Fülöp A, Oláh A, Szijártó A. Case report of actinomycotic liver abscess following COVID-19 infection. Ann Med Surg (Lond) 2022; 82:104525. [PMID: 36092857 PMCID: PMC9444312 DOI: 10.1016/j.amsu.2022.104525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction and importance In the last few years, the novel coronavirus, named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), generated a large health care problem worldwide. Due to the immunomodulation effect of the virus the number of opportunistic infections has also increased. Case presentation We present the unique case of a patient who was diagnosed with an actinomycotic liver abscess after coronavirus disease 2019 (COVID-19) without the presence of any chronic disease or mucosal injury. Clinical discussion According to the results of the computer tomography (CT scan) and the liver biopsy, the patient was treated with antibiotics and ultrasound-guided drainage. Conclusion With this case we would like to draw attention to the possible occurrence of liver abscesses caused by an opportunistic pathogen following COVID-19. SARS-CoV-2 is an acute respiratory infection, that could result immune dysregulation. Immunocompromised patients have a higher risk for opportunistic infections (e.g. actinomycosis). Actinomycosis could result in liver abscess, which is a rare type of the liver abscesses. Actinomycosis followed by COVID-19 infection disease could be a post-COVID syndrome.
Collapse
Affiliation(s)
- Klára Lévay
- Department of Surgery, Transplantation and Gastroenterology, Hepato-Pancreatico-Biliary (HPB) Surgical Research Center Hungary, Semmelweis University, Budapest, Hungary
- Corresponding author.. Üllői út 78, Budapest, H-1082, Hungary.
| | - Noémi Daradics
- Department of Surgery, Transplantation and Gastroenterology, Hepato-Pancreatico-Biliary (HPB) Surgical Research Center Hungary, Semmelweis University, Budapest, Hungary
| | - Tibor Horváth
- Department of Gastroenterology, Soproni Erzsébet Teaching Hospital and Rehabilitation Institute, Sopron, Hungary
| | - Tibor Kovács
- Surgical Department, Petz Aladár University Hospital, Győr, Hungary
| | - András Fülöp
- Department of Surgery, Transplantation and Gastroenterology, Hepato-Pancreatico-Biliary (HPB) Surgical Research Center Hungary, Semmelweis University, Budapest, Hungary
| | - Attila Oláh
- Surgical Department, Petz Aladár University Hospital, Győr, Hungary
| | - Attila Szijártó
- Department of Surgery, Transplantation and Gastroenterology, Hepato-Pancreatico-Biliary (HPB) Surgical Research Center Hungary, Semmelweis University, Budapest, Hungary
| |
Collapse
|
10
|
Abdominopelvic Actinomycosis: An Unexpected Diagnosis in an Elderly Female with a Destructive-Appearing Soft Tissue Mass. IDCases 2022; 28:e01479. [PMID: 35345557 PMCID: PMC8957024 DOI: 10.1016/j.idcr.2022.e01479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 11/20/2022] Open
|
11
|
Miyamoto K, Matsumoto K, Ocho K, Fujita K, Horiguchi S, Takenaka R, Fujiki S. Pancreatic actinomycosis treated by antibiotics after diagnosis using endoscopic ultrasound-guided fine-needle biopsy. Clin J Gastroenterol 2021; 14:1785-1790. [PMID: 34554394 DOI: 10.1007/s12328-021-01523-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/12/2021] [Indexed: 11/26/2022]
Abstract
A 71-year-old man who had undergone total gastrectomy, partial pancreatectomy, and splenectomy with Roux-en-Y reconstruction for gastric cancer was referred for a possible pancreatic tail tumor. Contrast-enhanced computed tomography showed mold-like, poor contrast lesion in the dilated main pancreatic duct in the pancreatic tail. Endoscopic ultrasonography revealed a slightly hyperechoic solid lesion that occupied the lumen of the main pancreatic duct. Linear calcification was observed in the lesions on both computed tomography and endoscopic ultrasonography, and endoscopic ultrasound-guided fine-needle biopsy was performed. Histopathology revealed sulfur grains and inflammatory infiltrates with no malignant findings. We also performed an anaerobic culture using fine-needle biopsy specimens, and Actinomyces meyeri was detected in the culture results. After confirming susceptibility, oral administration of amoxicillin was initiated. After 8 months of treatment, the size of the lesion slightly decreased, and the antibiotics treatment is still ongoing. This shows that such cases could be diagnosed based on histological findings and anaerobic culture using a fine-needle biopsy specimen, and unnecessary surgery may be avoided. In the case of tumors developed in the residual pancreas without typical malignant imaging findings, pancreatic actinomycosis should be considered as a differential diagnosis.
Collapse
Affiliation(s)
- Kazuya Miyamoto
- Department of Internal Medicine, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama-shi, Okayama, 708-0841, Japan.
| | - Kazuyuki Matsumoto
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Kazuki Ocho
- Department of Internal Medicine, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama-shi, Okayama, 708-0841, Japan
| | - Koji Fujita
- Department of Internal Medicine, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama-shi, Okayama, 708-0841, Japan
| | - Shigeru Horiguchi
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Ryuta Takenaka
- Department of Internal Medicine, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama-shi, Okayama, 708-0841, Japan
| | - Shigeatsu Fujiki
- Department of Internal Medicine, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama-shi, Okayama, 708-0841, Japan
| |
Collapse
|
12
|
Saito M, Shinozaki-Kuwahara N, Hashizume-Takizawa T, Gotouda H, Senpuku H, Kurita-Ochiai T. Actinomyces capricornis sp. nov., isolated from the oral cavity of a Japanese serow. Microbiol Immunol 2021; 65:559-565. [PMID: 34536031 DOI: 10.1111/1348-0421.12941] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/26/2021] [Accepted: 09/09/2021] [Indexed: 11/30/2022]
Abstract
A novel Gram-positive, facultatively anaerobic, rod-shaped, nonspore forming, nonmotile organism was isolated from a Japanese serow oral cavity. Designated strain MAS-1T , it is most closely related to Actinomyces bowdenii DSM 15435T , with which it shares 98.07% sequence homology in the 16S ribosomal RNA gene. The primarily detected cellular fatty acids in strain MAS-1T were C16:0 and C18:1 w9c. The predominant respiratory quinone was MK-9 (H4 ). The major polar lipids were phosphatidylcholines, phosphatidylinositols, and glycophospholipids. The genomic DNA GC content of the isolate was 71.3 mol%. The digital DNA-DNA hybridization and average nucleotide identity values between MAS-1T and its related species were 23.5%-39.5% and 82.11%-91.01%, respectively, which were below the threshold (70% and 95%, respectively) for species delineation, indicating that strain MAS-1T represents a novel species. Strain MAS-1T can be differentiated from A. bowdenii by their reactions to naphthol-AS-BI-phosphohydrolase, α-galactosidase, β-galactosidase, and N-acetyl-β-glucosaminidase, as well as differing acid production from glycogen. Based on the results of genotypic, phenotypic, and biochemical analyses, herein it is proposed that the identified bacteria can be classified as a novel species, Actinomyces capricornis sp. nov., strain MAS-1T (=JCM 34236T = DSM 111732T ).
Collapse
Affiliation(s)
| | | | | | - Hiroya Gotouda
- Community Oral Health, Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | | | | |
Collapse
|
13
|
Xu YY, Zhang J, Lu AL, Peng J, Xu XW. Clinical features of actinomycosis: A 20-year experience of a single institute in Southern China. J Mycol Med 2021; 31:101169. [PMID: 34224940 DOI: 10.1016/j.mycmed.2021.101169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 01/11/2021] [Accepted: 06/16/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Actinomycosis is a rare indolent infectious disease with nonspecific clinical presentations that delay diagnosis. Although actinomycosis is thought to be more prevalent in developing countries, data from developing countries are scarce. This study aimed to profile actinomycosis in developing countries and identify how it differed from profiles of developed countries. METHODS Patients fulfilling the inclusion criteria for actinomycosis from Nanfang Hospital in southern China between January 1999 and December 2018 were retrospectively analyzed. We described clinical characteristics, diagnostic procedures, differential diagnosis, and management of actinomycosis of clinical significance. RESULTS Thirty‑one patients were included in this study. The disease was diagnosed predominately in the orocervicofacial (n = 14), cardiothoracic (n = 11), abdominopelvic (n = 5), and soft tissue (n = 1) regions. Diagnosis was obtained by either histopathology (n = 29, 94%) or microbiology (n = 2, 6%). Only one-third of patients presented with general symptoms, such as fever and weight loss. Ten were lost during follow-up, and the median duration of antibiotic use was 93.5 days (interquartile range 28-300), whereas the median follow-up time was 34 months (interquartile range 9-132). Ten patients receiving complete resection of the lesion were cured without postoperative use of antibiotics. Only one patient relapsed during the follow-up period. CONCLUSIONS Actinomycosis is a rare disease even in developing countries, and both misdiagnosis and missed diagnosis are common. Diagnosis was often delayed and was obtained postoperatively from histopathology in developing countries. Hence, clinicians should be aware of this disease in patients with high risk factors. In the future, specific molecular methods may help to improve early diagnosis and treatment.
Collapse
Affiliation(s)
- Yu-Yuan Xu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jian Zhang
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Ai-Li Lu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Jie Peng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Xu-Wen Xu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
| |
Collapse
|
14
|
Gandhi K, van der Woerd BD, Graham ME, Barton M, Strychowsky JE. Cervicofacial Actinomycosis in the Pediatric Population: Presentation and Management. Ann Otol Rhinol Laryngol 2021; 131:312-321. [PMID: 34060325 PMCID: PMC8814968 DOI: 10.1177/00034894211021273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Infection caused by Actinomyces species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis. METHODS Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region. RESULTS Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and prolonged antibiotic therapy. Thirty-four pediatric cases of cervicofacial actinomycosis are reviewed, 2 presented herein, and 32 from the published literature. There was equal gender distribution and the median age was 7.5 years. The most common site for infection was the submandibular area. Four (12%) of cases arose in pre-existing congenital lesions. Most patients were treated with penicillin-based antibiotics for a median duration of 6 months following surgical excision or debridement. CONCLUSIONS Actinomycosis is a rare infection of the cervicofacial region; secondary infections arising from congenital lesions of the head and neck are even more rare. A previously excised pre-auricular sinus and a sublingual dermoid cyst are not previously reported sites of infection. Actinomycosis should be suspected in chronically draining sinuses of the head and neck region and confirmed through anaerobic culture. Osteomyelitis is a potential complication and magnetic resonance (MR) imaging is warranted. Long-term antibiotic therapy with a penicillin-based antibiotic and surgical excision should be considered.
Collapse
Affiliation(s)
- Karan Gandhi
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Benjamin D van der Woerd
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
| | - M Elise Graham
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.,Department of Pediatrics, Western University, London, ON, Canada
| | - Michelle Barton
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Pediatrics, Western University, London, ON, Canada
| | - Julie E Strychowsky
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.,Department of Pediatrics, Western University, London, ON, Canada
| |
Collapse
|
15
|
Landman-Vu J, Fayet B, Racy E, Hanna NG, Merle H. Primary Lacrimal Canaliculitis with clinically detected concretions: One-snip punctoplasty with lateral canaliculotomy vs. punctum sparing canalicular curettage. J Fr Ophtalmol 2021; 44:855-862. [PMID: 34020811 DOI: 10.1016/j.jfo.2020.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 08/10/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To compare two distinct surgical techniques in the management of chronic Primary Lacrimal Canaliculitis (PLC) with clinically detectable concretions. MATERIALS AND METHODS Inclusion criteria: Patients presenting with symptoms consistent with the diagnosis of primary lacrimal canaliculitis (PLC) with ocular involvement were gathered. Gomori-Grocott Methenamine Silver test was used for concretion staining. Two groups were identified based on the surgical technique. Group A consisted of patients who underwent a punctum sparing canalicular curettage using a chalazion curette, while the patients in Group B underwent one-snip punctoplasty with lateral canaliculotomy. Failure was defined as recurrence of the initial symptoms at any time (ocular and canalicular inflammation with purulent discharge and pouting punctum). The results were analyzed by comparisons using a Fisher's exact test. RESULTS Ninety-six consecutive patients (96) with a confirmed diagnosis of PLC underwent surgical treatment between 1987 and 2017. Data were collected and divided based on the surgical technique discussed above (Group A and B). Group A: 51 cases with a mean follow-up time of 22 months [1-224] presented with a mean age of 51.5 [25-83] and a surgical failure rate of 19.6%. Group B: 45 patients with a mean follow-up time of 27 months [1-176], a mean age of 68 [17-87] years and a surgical failure rate of 4.4%. Statistical significance was demonstrated, with a p-value of 0.033, odds ratio (OR) of 0.1936 and Standard Deviation (SD) at a 95% confidence interval of [0.0195-0.9885]. CONCLUSIONS One-snip punctoplasty with lateral canaliculotomy is a simple, fast and effective procedure that allows better anatomical visualization intraoperatively and is thus shown to be statistically superior to punctum sparing canalicular curettage using a chalazion curette.
Collapse
Affiliation(s)
- J Landman-Vu
- OphtalmoPôle, Hôpital Cochin, 27, rue du Faubourg Saint Jacques, 75014 Paris, France.
| | - B Fayet
- OphtalmoPôle, Hôpital Cochin, 27, rue du Faubourg Saint Jacques, 75014 Paris, France
| | - E Racy
- ENT, Fondation Saint Jean de Dieu, 2, rue Rousselet, 75007 Paris, France
| | - N-G Hanna
- OphtalmoPôle, Hôpital Cochin, 27, rue du Faubourg Saint Jacques, 75014 Paris, France
| | - H Merle
- CHU Pierre Zobda Quitman, CS 90632, Fort de France Cedex, France
| |
Collapse
|
16
|
Reeves JM, Ip JCY. Not just a simple appendicectomy: abdominal actinomycosis causing phlegmonous appendicitis. ANZ J Surg 2021; 91:E791-E792. [PMID: 33913228 DOI: 10.1111/ans.16904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Jenna M Reeves
- Department of Surgery, Hornsby Ku-ring-Gai Hospital, Sydney, New South Wales, Australia
| | - Julian C Y Ip
- Department of Surgery, Hornsby Ku-ring-Gai Hospital, Sydney, New South Wales, Australia.,Department of General Surgery, Northern Beaches Hospital, Sydney, New South Wales, Australia.,Department of Clinical Medicine, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
17
|
Brondfield S, Rubio L, Idossa D, Chin-Hong P. Malignant Masses or Mysterious Mimic? Am J Med 2021; 134:e217-e219. [PMID: 33002492 DOI: 10.1016/j.amjmed.2020.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Sam Brondfield
- University of California, San Francisco, Department of Medicine, Division of Hematology/Oncology.
| | - Luis Rubio
- University of California, San Francisco, Department of Medicine, Division of Infectious Diseases
| | - Damé Idossa
- University of California, San Francisco, Department of Medicine, Division of Hematology/Oncology
| | - Peter Chin-Hong
- University of California, San Francisco, Department of Medicine, Division of Infectious Diseases
| |
Collapse
|
18
|
Babcock CP, Pullen MF, Manivel JC, Yamanaka BM, Kaka A. A 66-Year-Old Man With Progressive Chest Pain, Dyspnea, and Incomplete Paraplegia of the Lower Extremities. Clin Infect Dis 2021; 70:2743-2746. [PMID: 32520329 DOI: 10.1093/cid/ciz870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Corey P Babcock
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Matthew F Pullen
- Division of Infectious Disease and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Juan C Manivel
- Anatomic Pathology, Veterans Affairs Medical Center, and Pathology and Urology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Bradley M Yamanaka
- Section of Hospital Medicine, Veterans Affairs Medical Center, and Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Anjum Kaka
- Section of Infectious Disease, Veterans Affairs Medical Center, and Division of Infectious Disease and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
19
|
Vargová L, Horáčková L, Vymazalová K, Němečková A, Tvrdý Z, Galuška L, Mitáček J, Fialová D. A very rare case of possible actinomycosis of the mandible from the Middle Ages. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2020; 31:53-59. [PMID: 32949891 DOI: 10.1016/j.ijpp.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Documented cases of actinomycosis in archaeological skeletons are very rare, especially from Central Europe. Our contribution will help facilitate the differential diagnosis of this disease for other paleopathologists. MATERIAL This paper describes a pathological finding of the skeleton of a 40-year-old male from a burial ground in Sady-Špitálky (Czech Republic) dated to the 10th-12th century. METHODS The affected skeleton was evaluated as a probable case of actinomycosis on the basis of a detailed macroscopic, X-ray and histological examination. The osteolytic foci examined were compared with similar changes caused by tuberculosis, syphilis and mycoses. RESULTS The character and location of the defect on the mandible is indicative of organ actinomycosis and is also reflected by the lytic lesion observed on a lumbar vertebra. CONCLUSIONS The described case can be considered one of the very rare paleopathological findings of possible actinomycosis in humans in Central Europe. SIGNIFICANCE Good evidence of bone actinomycosis findings may be beneficial for further paleopathological and epidemiological studies, especially for research focused on the diachronic development of actinomycosis in Europe. In doing so, all available factors, such as hygiene habits, nutrition, social structure and overall health of the population that could be causally related to its origin, course and treatment, can be taken into account. LIMITATIONS The mandible of the studied individual was damaged, especially in the area affected by the lesion, so the paleopathological analysis was difficult to perform. SUGGESTION FOR THE FUTURE RESEARCH In future, actinomycosis in this skeleton may be confirmed by bio-molecular analysis.
Collapse
Affiliation(s)
- Lenka Vargová
- Division of Medical Anthropology, Department of Anatomy, Faculty of Medicine, Masaryk University, Kamenice 3, 625 00 Brno, Czech Republic.
| | - Ladislava Horáčková
- Division of Medical Sciences in Sports, Department of Kinesiology, Faculty of Sports Studies, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic.
| | - Kateřina Vymazalová
- Division of Medical Anthropology, Department of Anatomy, Faculty of Medicine, Masaryk University, Kamenice 3, 625 00 Brno, Czech Republic.
| | - Alena Němečková
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00, Pilsen, Czech Republic.
| | - Zdeněk Tvrdý
- Anthropos Institute, Moravian Museum, Zelný trh 6, 659 37, Brno, Czech Republic.
| | - Luděk Galuška
- Centre for Slavonic Archaeology, Moravian Museum, Velehradská třída 537, 686 01, Uherské Hradiště, Czech Republic.
| | - Jiří Mitáček
- Moravian Museum, Zelný trh 6, 659 37, Brno, Czech Republic.
| | - Dana Fialová
- Laboratory of Biological and Molecular Anthropology, Department of Experimental Biology, Faculty of Science, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
| |
Collapse
|
20
|
Hartert M, Wolf M, Ferber J, Huertgen M. Thoracoabdominal actinomycosis - Chameleon through kaleidoscope. Respir Med Case Rep 2020; 31:101281. [PMID: 33251103 PMCID: PMC7677701 DOI: 10.1016/j.rmcr.2020.101281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/08/2020] [Accepted: 11/02/2020] [Indexed: 11/22/2022] Open
Abstract
Actinomyces is a gram-positive anaerobic bacterium that generally inhabits the human commensal flora of the bronchial system, the gastrointestinal and urogenital tract. In the rare case of becoming invasive under certain circumstances, the resulting Actinomycosis affects most commonly cervicofacial, thoracic, abdominal and pelvic regions. Due to its rarity and presenting with nonspecific clinical symptoms, thoracic and/or abdominal Actinomycosis in particular are highly intriguing clinical conditions that can easily be mistaken for other diseases including malignancies. Astute considerations are therefore necessary whenever we are challenged diagnostically to allow early diagnosis and thus avoiding gratuitous invasive surgery. In order to highlight different issues of this ultimate chronic disease we report a particular case of thoracoabdominal Actinomycosis.
Collapse
Affiliation(s)
- Marc Hartert
- Department of Thoracic Surgery, Katholisches Klinikum Koblenz-Montabaur, Koblenz, Germany
| | - Michael Wolf
- Department of Thoracic Surgery, Katholisches Klinikum Koblenz-Montabaur, Koblenz, Germany
| | | | - Martin Huertgen
- Department of Thoracic Surgery, Katholisches Klinikum Koblenz-Montabaur, Koblenz, Germany
| |
Collapse
|
21
|
Dioguardi M, Quarta C, Alovisi M, Crincoli V, Aiuto R, Crippa R, Angiero F, Laneve E, Sovereto D, De Lillo A, Troiano G, Lo Muzio L. Microbial Association with Genus Actinomyces in Primary and Secondary Endodontic Lesions, Review. Antibiotics (Basel) 2020; 9:E433. [PMID: 32707891 PMCID: PMC7460180 DOI: 10.3390/antibiotics9080433] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/14/2020] [Accepted: 07/21/2020] [Indexed: 12/26/2022] Open
Abstract
The main reason for root canal treatment failure is the persistence of microorganisms after therapy, or the recontamination of the root canal system due to an inadequate seal. In the mouth, Actinomyces spp. constitute a significant part of the normal flora, which is indicative of their ability to adhere to oral tissue and resist cleansing mechanisms, such as salivary flow. This review, performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), aims to clarify the prevalence of microbial genera that are associated with the genus Actinomyces in primary and secondary endodontic infections (primary outcome), and to identify the most prevalent species of the Actinomyces genus in endodontic lesions (secondary outcome). A total of 11 studies were included in the qualitative and quantitative analysis, and a total of 331 samples were analyzed. Bacteria of the genus Actinomyces were found in 58 samples, and 46 bacterial genera were detected in association with bacteria of the genus Actinomyces. Bacteria of the genus Streptococcus and Propionibacterium were those most frequently associated with Actinomyces in the endodontic lesions considered, and Actinomyces israelii was the most frequently involved species.
Collapse
Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (E.L.); (D.S.); (A.D.L.); (G.T.); (L.L.M.)
| | - Cristian Quarta
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (E.L.); (D.S.); (A.D.L.); (G.T.); (L.L.M.)
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, 10127 Turin, Italy;
| | - Vito Crincoli
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, Division of Complex Operating Unit of Dentistry, “Aldo Moro” University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy;
| | - Riccardo Aiuto
- Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy;
| | - Rolando Crippa
- Department of Oral Pathology, Italian Stomatological Institute, 20122 Milan, Italy;
| | - Francesca Angiero
- Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genova, 16132 Genova, Italy;
| | - Enrica Laneve
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (E.L.); (D.S.); (A.D.L.); (G.T.); (L.L.M.)
| | - Diego Sovereto
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (E.L.); (D.S.); (A.D.L.); (G.T.); (L.L.M.)
| | - Alfredo De Lillo
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (E.L.); (D.S.); (A.D.L.); (G.T.); (L.L.M.)
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (E.L.); (D.S.); (A.D.L.); (G.T.); (L.L.M.)
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.Q.); (E.L.); (D.S.); (A.D.L.); (G.T.); (L.L.M.)
| |
Collapse
|
22
|
Sethy SS, Singh V, Choudhury AK, Singh G, Gupta PK, Mehta V. Actinomycotic Osteomyelitis of the Hand and Wrist Treated with Pharmacotherapy Alone: A Case Report. JBJS Case Connect 2020; 10:e1900520. [PMID: 32668139 DOI: 10.2106/jbjs.cc.19.00520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
CASE Primary infection by Actinomyces is uncommon because susceptibility to infection requires breakdown of the normal protective mucosal barrier. Furthermore, involvement of the upper extremity is rare. This case report presents clinical, radiological, and pathological findings in a 26-year-old patient with actinomycosis of the hand that was treated successfully by pharmacotherapy alone without any surgical debridement. CONCLUSION Primary actinomycoses of the hand and upper extremity present as a challenging condition. It requires a high index of clinical suspicion and histopathologic diagnosis to guide treatment, typically involving antimicrobial therapy. This case highlights the usefulness of conservative treatment with antimicrobial therapy without surgical debridement.
Collapse
Affiliation(s)
- Siddharth Sekhar Sethy
- 1Department of orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India 2Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | | | | | | | | | | |
Collapse
|
23
|
Li C, Zhang P, Jiao G, Lv J, Ma C, Song X, Zhang J, Wu C, Li R, Zhu H. Mimicking uterine malignancy: Pelvic actinomycosis with giant uterine leiomyoma. IDCases 2020; 23:e00878. [PMID: 33294369 PMCID: PMC7691182 DOI: 10.1016/j.idcr.2020.e00878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 11/30/2022] Open
Abstract
Pelvic actinomycosis is a rare disease which is hard to be distinguished from other diseases such as malignant tumors and tuberculosis due to its nonspecific clinical signs and symptoms. If pelvic actinomycosis can be diagnosed preoperatively, the patients can be cured with antimicrobial therapy avoiding surgery. It is especially of concern to distinguish pelvic actinomycosis from pelvic mass, if there is a history of intrauterine device use. We report a case of pelvic actinomycosis that was diagnosed after the postoperative pathology of a suspected uterine malignancy.
Collapse
Affiliation(s)
- Changzai Li
- Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Pan Zhang
- College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei, China
| | - Guimei Jiao
- Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Jie Lv
- Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Chunmei Ma
- Department of Computed Tomography, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Xudong Song
- Department of Pathology, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Jinji Zhang
- Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Chuntao Wu
- Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Ruiwei Li
- Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Hongcheng Zhu
- Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| |
Collapse
|
24
|
Sia GB, Soares PFC, Benedetti L, Moreira LR, Cazzo E. Abdominal Actinomycosis After Bariatric Surgery. Obes Surg 2020; 31:405-408. [PMID: 32557388 DOI: 10.1007/s11695-020-04784-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Gabriela B Sia
- Faculty of Medicine, Pontifícia Universidade Católica de Campinas (PUCCAMP), Campinas, SP, Brazil
| | - Pedro F C Soares
- Department of Surgery - Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Lucas Benedetti
- Department of Surgery, Centro Médico de Campinas (CMC), Campinas, SP, Brazil
| | | | - Everton Cazzo
- Department of Surgery - Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
- Departamento de Cirurgia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM/UNICAMP), Rua Alexander Fleming, s/n°, Cidade Universitaria Zeferino Vaz, Cempinas, SP, 13085-000, Brazil.
| |
Collapse
|
25
|
Han Y, Cao Y, Zhang Y, Niu L, Wang S, Sang C. A Case Report of Pelvic Actinomycosis and a Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e922601. [PMID: 32532952 PMCID: PMC7476745 DOI: 10.12659/ajcr.922601] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of this study was to report the clinical diagnosis and treatment of a case of pelvic actinomycosis in our hospital and provide a review of recent literature. CASE REPORT The patient was a 54-year-old woman who was admitted to our hospital due to "bilateral lower abdominal tenderness accompanied with anorexia and vomiting for 3 months". After admission, a variety of imaging examinations found pelvic space-occupying lesions, which were considered as malignant. She underwent surgery and pelvic actinomycosis was diagnosed by postoperative pathology. Postoperatively, she was treated with a high-dose sufficient course of penicillin (20 million U, iv gtt) for 14 days and she is currently under close follow-up for 1 year, with no recurrent symptoms. CONCLUSIONS Pelvic actinomycosis is rare and often forms mass invasion into the tissue structure around the pelvic cavity, which is easily misdiagnosed as ovarian malignant tumor. The criterion standard for diagnosing an infection is culture, with histopathology aiding the diagnosis.
Collapse
Affiliation(s)
- Ying Han
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - Yang Cao
- Department of Obstetrics and Gynecology, Beijing Huai-Rou Hospital, Beijing, China (mainland)
| | - YanJun Zhang
- Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - Lin Niu
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - ShuZhen Wang
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| | - CuiQin Sang
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (mainland)
| |
Collapse
|
26
|
Kobayashi T, Ford B, Fujita N, Appenheimer AB. Ocular Actinomycosis Mimicking Meningioma. Open Forum Infect Dis 2020; 7:ofaa170. [PMID: 32529000 PMCID: PMC7273183 DOI: 10.1093/ofid/ofaa170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 05/14/2020] [Indexed: 11/14/2022] Open
Abstract
Orbital actinomycosis is an unusual clinical manifestation of orbital infection caused by Actinomyces species. Herein we report a case of orbital actinomycosis in a 67-year-old woman with recurrent swelling and erythema around her left eye with an orbital mass initially thought to be a meningioma.
Collapse
Affiliation(s)
- Takaaki Kobayashi
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Bradley Ford
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Nobuhiro Fujita
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - A Ben Appenheimer
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| |
Collapse
|
27
|
Abstract
Actinomycosis is a rare bacterial disease characterized by chronic or subacute suppurative inflammation. Abdominal actinomycosis is rarer and accounts for approximately 20% of all actinomycosis cases. In the literature, patients who underwent surgery for actinomycosis mimicking malignant tumors have been reported. Most of these patients had mucosal trauma and inflammation signs. It is often difficult to diagnose abdominal actinomycosis preoperatively and often impossible to distinguish it from a malignant tumor. We present a case that preoperatively was diagnosed as a malignant tumor but pathological evaluation reported to be diverticulitis and actinomycosis. This case can increase the awareness about this disease, which is possible to be treated non-surgically.
Collapse
Affiliation(s)
- Ramazan Sari
- Department of General Surgery, Baskent University, Adana, Turkey
| | - Murat Kuş
- Department of General Surgery, Baskent University, Adana, Turkey
| | | |
Collapse
|
28
|
Seong GM, Hyun CL, Chang JW, Kim C. Unusual aetiology of lymphocyte-predominant exudative pleural effusion: primary mediastinal actinomycosis. Respirol Case Rep 2020; 8:e00534. [PMID: 32148837 PMCID: PMC7020314 DOI: 10.1002/rcr2.534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 12/25/2019] [Accepted: 01/28/2020] [Indexed: 11/06/2022] Open
Abstract
Actinomycosis is a rare infectious bacterial disease typically involving cervicofacial, abdominopelvic, or thoracic regions, caused by Actinomyces species. However, involvement of the mediastinum as the primary site of origin is extremely rare. An elderly patient complained of left-sided chest pain. The chest radiograph revealed pleural effusion, which revealed lymphocyte-predominant exudates. Chest computed tomography showed a soft tissue mass in the left anterior mediastinum. Positron emission tomography revealed an increased uptake of 18F-fluorodeoxyglucose in this lesion. To exclude malignancy and make a confirmative diagnosis, a mediastinal biopsy was performed through video-assisted thoracic surgery. Finally, mediastinal actinomycosis was diagnosed. We report herein a case of mediastinal actinomycosis mimicking lung malignancy presented with recurrent lymphocyte-predominant pleural fluid exudate. In patients with a recurrent or unexplained exudative pleural effusion, it may be worthwhile to consider a hidden foci of actinomycosis.
Collapse
Affiliation(s)
- Gil Myeong Seong
- Department of Internal MedicineJeju National University Hospital, Jeju National University School of MedicineJejuRepublic of Korea
| | - Chang Lim Hyun
- Department of PathologyJeju National University Hospital, Jeju National University School of MedicineJejuRepublic of Korea
| | - Jee Won Chang
- Department of Thoracic and Cardiovascular SurgeryJeju National University Hospital, Jeju National University School of MedicineJejuRepublic of Korea
| | - Changhwan Kim
- Department of Internal MedicineJeju National University Hospital, Jeju National University School of MedicineJejuRepublic of Korea
| |
Collapse
|
29
|
Li J, Lu S, Yang J, Pu J, Lai XH, Jin D, Tian Z, Dong K, Zhang S, Lei W, Zhu W, Zhang G, Ren Z, Wu X, Huang Y, Wang S, Meng X, Xu J. Actinomyces lilanjuaniae sp. nov., isolated from the faeces of Tibetan antelope ( Pantholops hodgsonii) on the Qinghai-Tibet Plateau. Int J Syst Evol Microbiol 2019; 69:3485-3491. [PMID: 31460856 DOI: 10.1099/ijsem.0.003649] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Two novel, Gram-stain-positive, non-motile, facultatively anaerobic, rod-shaped bacteria (strains 2129T and 2119) were isolated from the faeces of Tibetan antelopes (Pantholops hodgsonii) on the Qinghai-Tibet Plateau, PR China. The 16S rRNA gene sequences of the strains showed highest similarity values to Actinomyces timonensis DSM 23838T (92.9 and 92.8 %, respectively), and phylogenetic analysis based on 16S rRNA gene and genomic sequences indicated that strains 2129T and 2119 represent a new lineage. Strains 2129T and 2119 could ferment d-adonitol and d-xylose, but were unable to utilize d-mannose and d-melibiose nor produce esterase (C4) and proline arylamidase. The G+C contents of the two strains were both 69.0 mol%. Their genomes exhibited less than 40.4 % relatedness in DNA-DNA hybridization tests (below 70 % as the recommended threshold for new species) with all available genomes of the genus Actinomyces in the NCBI database. The major fatty acids of the two strains were C18 : 1ω9c and C16 : 0, and the major polar lipids were diphosphatidylglycerol, glycolipid, phosphatidylinositol, phosphatidyl inositol mannoside and phosphoglycolipid. Based on the results of genotypic, phenotypic and biochemical analyses, it is proposed that the two unidentified bacteria be classified as representing a novel species, Actinomyces lilanjuaniae sp. nov. The type strain is 2129T (=CGMCC 4.7483T=DSM 106426T).
Collapse
Affiliation(s)
- Junqin Li
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, Shanxi 030001, PR China
| | - Shan Lu
- Shanghai Institute for Emerging and Re-emerging infectious diseases, Shanghai Public Health Clinical Center, Shanghai, 201508, PR China.,State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Jing Yang
- Shanghai Institute for Emerging and Re-emerging infectious diseases, Shanghai Public Health Clinical Center, Shanghai, 201508, PR China.,State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Ji Pu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Xin-He Lai
- School of Biology and Food Sciences, Shangqiu Normal University, Henan province, 475000, PR China
| | - Dong Jin
- Shanghai Institute for Emerging and Re-emerging infectious diseases, Shanghai Public Health Clinical Center, Shanghai, 201508, PR China.,State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Zhi Tian
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, Shanxi 030001, PR China
| | - Kui Dong
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, Shanxi 030001, PR China
| | - Sihui Zhang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, Shanxi 030001, PR China
| | - Wenjing Lei
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, Shanxi 030001, PR China
| | - Wentao Zhu
- Shanghai Institute for Emerging and Re-emerging infectious diseases, Shanghai Public Health Clinical Center, Shanghai, 201508, PR China
| | - Gui Zhang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Zhihong Ren
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Xiaomin Wu
- Shaanxi Institute of Zoology, Xi'an, Shaanxi Province, 710032, PR China
| | - Ying Huang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Suping Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, Shanxi 030001, PR China
| | - Xiangli Meng
- Ningbo International Travel Healthcare Center, Ningbo Customs District People's Republic of China, Ningbo, 315012, PR China
| | - Jianguo Xu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China.,Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, Shanxi 030001, PR China
| |
Collapse
|
30
|
|
31
|
Kobayashi T, Arshava E, Ford B, Sekar P. Mixed Actinomyces israelii and Aggregatibacter actinomycetemcomitans infection causing empyema necessitatis and multiple skin abscesses in an immunocompetent patient. BMJ Case Rep 2019; 12:12/9/e230287. [PMID: 31551318 DOI: 10.1136/bcr-2019-230287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 45-year-old- man presented with left chest wall pain, swelling and cough. Over a 2-month period he developed abscesses in the right foot, right anterior thigh, left buttock and left chest. Incision and drainage of the soft tissue abscesses and video-assisted thoracoscopic surgery to drain the loculated empyema contiguous with the chest wall abscess were performed as surgical management. Gram stain showed beaded Gram-positive rods and the culture initially grew Aggregatibacter actinomycetemcomitans and Eikenella corrodens Pathological evaluation of the pleura showed sulfur granules and organisms consistent with Actinomyces spp. on Gomori methenamine silver stain; Actinomyces israelii was recovered in culture with extended incubation. The patient was treated for 3 weeks with ceftriaxone and oral metronidazole, followed by oral amoxicillin. Culture of A. actinomycetemcomitans with other findings consistent with actinomycosis warrants 6-12 months of antibiotic therapy.
Collapse
Affiliation(s)
- Takaaki Kobayashi
- Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Evgeny Arshava
- Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Bradley Ford
- Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Poorani Sekar
- Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| |
Collapse
|
32
|
Elzein F, Kharraz R, Arab N, Alotaibi F, Almohaya A, Almutairy A. A case series of actinomycosis from a single tertiary care center in Saudi Arabia. IDCases 2019; 15:e00521. [PMID: 30937285 PMCID: PMC6430034 DOI: 10.1016/j.idcr.2019.e00521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/24/2019] [Accepted: 03/06/2019] [Indexed: 12/26/2022] Open
Abstract
Actinomycosis is an uncommon but curable chronic infection caused by Actinomyces spp. The cervicofacial region is the most susceptible to infection; however, other sites may also become infected. Data on the current prevalence of this rare disease in Riyadh, Saudi Arabia is lacking. We herein report a case series of four patients with actinomycosis from a single tertiary care center in Riyadh, Saudi Arabia. Three patients presented to us with slowly progressing actinomycosis and one patient developed an acute abdomen, secondary to viscus perforation. Two of the patients had cervicofacial disease, including hard palate actinomycosis. Tissue cultures were sent for three patients; however, tests for actinomycosis were negative. Subsequently, the diagnosis was made through histopathological examination. Therapy involved a combination of surgical resection and debridement and prolonged antimicrobial treatment tailored to each patient. The cases reported in this series highlight the difficulty in diagnosing actinomycosis. For most patients, the diagnosis was delayed or accidentally discovered on histopathological examination. We conclude that increased awareness among physicians is needed for early diagnosis and treatment of actinomycosis.
Collapse
Affiliation(s)
- Fatehi Elzein
- Infectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
| | - Razan Kharraz
- Infectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
| | - Nahlah Arab
- Colorectal Surgery Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
| | - Fadhel Alotaibi
- Histopathology Department, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
| | - Abdulellah Almohaya
- Infectious Diseases Unit, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
| | - Alya Almutairy
- ENT Department, Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
| |
Collapse
|
33
|
Caplan E, Deputy M, Arul D, Wilson J. Actinomycosis of the omentum with invasion of the abdominal wall, small bowel and transverse colon mimicking malignancy. BMJ Case Rep 2019; 12:12/1/bcr-2018-227728. [PMID: 30696650 DOI: 10.1136/bcr-2018-227728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report the case of a 59-year-old Russian man who presented with a painless, slow-growing, epigastric mass. CT revealed a large heterogeneous mass within the omentum infiltrating into adjacent tissues. During diagnostic laparoscopy, the omental mass was noted to be firm, raising the suspicion of malignancy. Surgical en-bloc resection of the mass, including the posterior rectus sheath, transverse colon and small bowel, was performed with primary anastomoses at laparotomy. Histological examination was inconsistent with malignancy and revealed the mass to be actinomycosis, confirmed by microscopy and gram staining. Surgical resection was followed by an 8-week course of penicillin and doxycycline antibiotic therapy. This treatment resulted in full clinical and radiological recovery with no complications. Although the clinical and radiological findings, in this case, were highly suspicious of malignancy, abdominal actinomycosis should be considered a differential diagnosis in patients with infiltrative abdominal masses and mild constitutional symptoms.
Collapse
Affiliation(s)
- Edward Caplan
- General Surgery, Whittington Health NHS Trust, London, United Kingdom
| | - Mohammed Deputy
- General Surgery, Whittington Health NHS Trust, London, United Kingdom
| | - Dhili Arul
- General Surgery, Whittington Health NHS Trust, London, United Kingdom
| | - Jonathan Wilson
- General Surgery, Whittington Health NHS Trust, London, United Kingdom
| |
Collapse
|
34
|
León Miranda R, Palacios Ball J, Reoyo Pascual JF. Acute abdomen caused by actinomycosis. Med Clin (Barc) 2019; 152:80-81. [PMID: 29784476 DOI: 10.1016/j.medcli.2018.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/17/2018] [Accepted: 04/19/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Raquel León Miranda
- Cirugía General y del Aparato Digestivo, Hospital Universitario de Burgos, Burgos, España.
| | | | | |
Collapse
|
35
|
|
36
|
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: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [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
| |
Collapse
|
37
|
Fong P, Francis MJ, Hamblin JF, Korman TM, Graham M. Identification and diversity of Actinomyces species in a clinical microbiology laboratory in the MALDI-TOF MS era. Anaerobe 2018; 54:151-158. [PMID: 30261272 DOI: 10.1016/j.anaerobe.2018.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 09/13/2018] [Accepted: 09/22/2018] [Indexed: 11/28/2022]
Abstract
Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has emerged as a reliable tool for bacterial identification. This study compared the Bruker MALDI-TOF BioTyper MS (MBT) and 16S rRNA gene sequencing for the identification of Actinomyces and Actinotignum spp. The MBT identified 68/77 (88.3%) of Actinomyces isolates to the genus-level and 44/77 (57.1%) of Actinomyces isolates to the species-level using the manufacturer's identification criteria. The MBT did not yield reliable identification for only 1/77 (1.3%) and generated no identification for 8/77 (10.4%) of the isolates. No misidentifications were found. Discordance at the species level was observed for eight isolates. Overall, the MBT demonstrated good concordance with the 16S rRNA gene sequencing with the exception of the closely related species A. naeslundii, A. viscosus and A. oris. A variety of Actinomyces spp. were isolated from orocervicofacial/dental specimens, but only a limited number of species were isolated from urine or intra-abdominal specimens. This study confirms the utility of MBT in the identification of Actinomyces spp. and describes the diversity and anatomic niche of species in human clinical specimens from various body sites.
Collapse
Affiliation(s)
- Peivern Fong
- Department of Microbiology, Monash Health, Clayton, Victoria, Australia.
| | | | - John F Hamblin
- Department of Microbiology, Monash Health, Clayton, Victoria, Australia
| | - Tony M Korman
- Department of Microbiology, Monash Health, Clayton, Victoria, Australia; Monash Infectious Diseases, Monash University, Monash Health, Clayton, Victoria, Australia
| | - Maryza Graham
- Department of Microbiology, Monash Health, Clayton, Victoria, Australia; Monash Infectious Diseases, Monash University, Monash Health, Clayton, Victoria, Australia
| |
Collapse
|
38
|
Mbogning Fonkou M, Mailhe M, Ndongo S, Ricaboni D, Morand A, Cornu F, Tidjani Alou M, Bilen M, Andrieu C, Levasseur A, Cadoret F, Raoult D. Noncontiguous finished genome sequences and descriptions of Actinomyces ihuae, Actinomyces bouchesdurhonensis, Actinomyces urinae, Actinomyces marseillensis, Actinomyces mediterranea and Actinomyces oralis sp. nov. identified by culturomics. New Microbes New Infect 2018; 25:30-44. [PMID: 29992027 PMCID: PMC6036942 DOI: 10.1016/j.nmni.2018.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/05/2018] [Accepted: 06/10/2018] [Indexed: 11/22/2022] Open
Abstract
The taxonogenomic approach, including the culturomics techniques, is now currently used to isolate and characterize new bacteria. These approaches notably allowed us to discover six new species of the Actinomyces genus: Actinomyces ihuae strain SD1, Actinomyces bouchesdurhonensis strain Marseille-P2825, Actinomyces urinae strain Marseille-P2225, Actinomyces marseillensis strain Marseille-P2818, Actinomyces mediterranea strain Marseille-P3257 and Actinomyces oralis strain Marseille-P3109. Each is the type strain of the corresponding bacterial species. 16S ribosomal RNA gene sequence comparison was used to classify these strains among the Actinomyces genus. These strains are all Gram positive, rod shaped and facultative aerobic. We describe the main characteristics of each bacterium and present their complete genome sequence and annotation.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - D. Raoult
- Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| |
Collapse
|
39
|
Lim JA, Wong PS, Leong KN, Wong KL, Chow TS. Masking and misleading: concomitant actinomycosis and B-cell lymphoma - a case report and review of literature. Scott Med J 2018; 63:36933018789312. [PMID: 30165794 DOI: 10.1177/0036933018789312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report a 72-year-old patient who presented with an ulcerated palatal mass, weight loss and adrenal insufficiency. Repeated biopsies from the mass revealed actinomycosis with no features of malignancy, while computed tomography scanning revealed a left maxillary sinus mass with invasive features and bilateral large adrenal masses. Blood and urine investigations showed adrenal insufficiency. The patient was treated as actinomycosis with adrenal involvement and was given intravenous penicillin and intravenous hydrocortisone. However, his condition did not improve and new signs appeared, that of left facial swelling and lymphadenopathy. A repeat biopsy of the palatal and adrenal masses revealed B-cell lymphoma. This case highlights the possibility that actinomycosis and lymphoma may share similar clinical presentations and may coexist. Either may mask and/or mimic the other, thus causing a delay in diagnosis. We describe the clinical progress and review the related literature. Interestingly, 9 out of the 12 reported cases of concomitant actinomycosis and malignancy (including this case) involve haematological malignancy. A high index of suspicion and treatment response reassessment is important in the management of either rare clinical entity.
Collapse
Affiliation(s)
- Jo Anne Lim
- 1 Medical Officer, Department of Medicine, Hospital Seberang Jaya, Penang, Malaysia
- 4 Medical Officer, Department of Medicine, Hospital Sultan Abdul Halim, Kedah, Malaysia
| | - Peng Shyan Wong
- 2 Consultant Infectious Diseases Physician, Infectious Diseases Unit, Penang General Hospital, Penang, Malaysia
| | - Kar Nim Leong
- 2 Consultant Infectious Diseases Physician, Infectious Diseases Unit, Penang General Hospital, Penang, Malaysia
| | - Kar Loon Wong
- 3 Registered Pharmacist, Department of Pharmacy, Penang General Hospital, Penang, Malaysia
| | - Ting Soo Chow
- 2 Consultant Infectious Diseases Physician, Infectious Diseases Unit, Penang General Hospital, Penang, Malaysia
| |
Collapse
|
40
|
Egal A, Etienney I, Beate H, Fléjou JF, Cuenod CA, Atienza P, Bauer P. Diagnosis and Management of a Cryptoglandular Actinomycotic Fistula-in-Ano: An Update on 7 New Cases and a Review of the Literature. Ann Coloproctol 2018; 34:152-156. [PMID: 29991204 PMCID: PMC6046537 DOI: 10.3393/ac.2017.07.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/23/2017] [Indexed: 12/11/2022] Open
Abstract
Purpose Primary anal actinomycosis of cryptoglandular origin, a rare cause of anal suppurative disease, requires specific management to be cured. The aims of this retrospective study were to describe clinical, morphological, and microbiological features of this entity and to evaluate management practices for new cases observed since 2001. Methods This was a retrospective case series conducted at the Diaconesses-Croix Saint-Simon Hospital in Paris. Results From January 2001 to July 2016, 7 patients, 6 males and 1 female (median, 49 years), presenting with an actinomycotic abscess with a cryptoglandular anal fistula were included for study. The main symptom was an acute painful ischioanal abscess. One patient exhibited macroscopic small yellow granules (“sulfur granules”), another “watery pus” and a third subcutaneous gluteal septic metastasis. All patients were overweight (body mass index ≥ 25 kg/m2). Histological study of surgically excised tissue established the diagnosis. All the patients were managed with a combination of classical surgical treatment and prolonged antibiotic therapy. No recurrence was observed during follow-up, the median follow-up being 3 years. Conclusion Actinomycosis should be suspected particularly when sulfur granules are present in the pus, patients have undergone multiple surgeries or suppuration has an unusual aspect. Careful histological examination and appropriate cultures of pus are needed to achieve complete eradication of this rare, but easily curable, disease.
Collapse
Affiliation(s)
- Axel Egal
- Department of Proctological Surgery, Diaconesses-Croix Saint-Simon Hospital, Paris, France
| | - Isabelle Etienney
- Department of Proctological Surgery, Diaconesses-Croix Saint-Simon Hospital, Paris, France
| | - Heym Beate
- Department of Microbiology, Diaconesses-Croix Saint-Simon Hospital, Paris, France
| | | | | | - Patrick Atienza
- Department of Proctological Surgery, Diaconesses-Croix Saint-Simon Hospital, Paris, France
| | - Pierre Bauer
- Department of Proctological Surgery, Diaconesses-Croix Saint-Simon Hospital, Paris, France
| |
Collapse
|
41
|
Paulo CO, Jordão S, Correia-Pinto J, Ferreira F, Neves I. Actinomycosis, a lurking threat: a report of 11 cases and literature review. Rev Soc Bras Med Trop 2018. [PMID: 29513846 DOI: 10.1590/0037-8682-0215-2017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Actinomycosis remains characteristically uncommon, but is still an important cause of morbidity. Its clinical presentation is usually indolent and chronic as slow growing masses that can evolve into fistulae, and for that reason are frequently underdiagnosed. Actinomyces spp is often disregarded clinically and is classified as a colonizing microorganism. In this review of literature, we concomitantly present 11 cases of actinomycosis with different localizations, diagnosed at a tertiary hospital between 2009 and 2016. We outline the findings of at least one factor of immunosuppression in > 90% of the reported cases.
Collapse
Affiliation(s)
- Catarina Oliveira Paulo
- Infectious Diseases Unit, Medical Department, Hospital Pedro Hispano - Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Sofia Jordão
- Infectious Diseases Unit, Medical Department, Hospital Pedro Hispano - Matosinhos Local Health Unit, Matosinhos, Portugal
| | - João Correia-Pinto
- Department of Anatomical Pathology, Hospital Pedro Hispano - Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Fernando Ferreira
- Department of General Surgery, Hospital Pedro Hispano - Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Isabel Neves
- Infectious Diseases Unit, Medical Department, Hospital Pedro Hispano - Matosinhos Local Health Unit, Matosinhos, Portugal
| |
Collapse
|
42
|
Abrego MO, De Cicco FL, Montenegro NB, Boretto JG, De Carli P, Gallucci GL. Refractory actinomycosis of the humerus. SAGE Open Med Case Rep 2018; 6:2050313X17752852. [PMID: 29348917 PMCID: PMC5768246 DOI: 10.1177/2050313x17752852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/18/2017] [Indexed: 11/15/2022] Open
Abstract
Actinomycosis is a chronic, opportunistic infection caused by Actinomyces species, such as Actinomyces bacillus. Actinomycosis in long bones is very rare. To the best of our knowledge, isolated primary actinomycosis of the humerus is rarely reported in literature. We present a rare case of a refractory primary actinomycosis of the humerus. A 66-year-old man with no history of concomitant conditions was admitted to our hospital with a history of a tumour on the distal third of the left arm as a result of a closed trauma without fracture 20 years before. Pathological anatomy samples showed the presence of Actinomyces. Cultures were subjected to a prolonged incubation of 21 days under aerobic and anaerobic conditions and were always negative. He underwent several surgical procedures and received long-term antibiotic therapy with poor outcome. Primary actinomycosis in long bones is uncommon. Diagnosis may be challenging: considering the small number of case studies reported in the literature, symptoms are not specific, and the organism is difficult to isolate. Antibiotic treatment may not be sufficient to improve the clinical condition, and surgical alternatives should be considered.
Collapse
Affiliation(s)
| | | | | | | | - Pablo De Carli
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | |
Collapse
|
43
|
Abdulla M. A progressive granulomatous disease mimicking tuberculosis. Lung India 2018; 35:357-358. [PMID: 29970782 PMCID: PMC6034371 DOI: 10.4103/lungindia.lungindia_428_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
44
|
Esteves LS, Henriques ÁCG, Silva CÁVDME, Cangussu MCT, Ramos EAG, Estrela C, Santos JND. Actinomycosis is not Frequent in the Periapex But is a Persistent Lesion. Braz Dent J 2017; 28:688-693. [PMID: 29211122 DOI: 10.1590/0103-6440201701449] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 07/05/2017] [Indexed: 11/21/2022] Open
Abstract
Periapical actinomycosis caused by a gram-positive anaerobic pathogen characterizes a typical extra-radicular infection. This study determined the frequency and correlated the content of bacteria colonies with the of periapical actinomycosis size. The study comprised a total of 218 periapical lesions (PL) (cysts, granulomas or abscess). The specimens embedded in paraffin were sliced into 4-µm sections and stained with hematoxylin-eosin, Gram, Periodic Acid-Schiff (PAS) and Grocott's stain. The presence of bacterial colonies composed of filamentous structures labeled with the histochemical stains were described as Actinomyces, and for each case, the bacterial colonies were counted and measured. The correlation between the number and size of bacterial colonies and the size of PL was tested using Pearson's adjusted correlation coefficient. From 218 PL, bacterial colonies were identified in 64 biopsies. Seven cases (0.3%) fulfill the criteria for diagnosis of periapical actinomycosis. All of cases were therapy-resistant and did not showed periapical repair after 12 months of follow-up. Periapical surgery or dental extraction was performed. The correlation test indicated no correlation between the number of bacterial colonies and the lesion size (p=0.752, r=-0.148). However, a larger bacterial colony size generally resulted in a larger periapical lesion (P=0.000, r=0.657). The frequency of periapical actinomycosis was low, and this lesion should be included in the differential diagnosis of PL. The size of the Actinomyces colonies seemed to contribute to increase the size of the periapical lesion.
Collapse
Affiliation(s)
- Lucas Senhorinho Esteves
- Dentistry and Health Postgraduate Program, Dental School, UFBA - Universidade Federal da Bahia, Salvador, BA, Brazil
| | | | | | | | - Eduardo Antônio Gonçalves Ramos
- Department of Pathology and Forensic Medicine, School of Medicine, UFBA - Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences,UFGO - Universidade Federal University de Goiás, Goiânia, GO, Brazil
| | - Jean Nunes Dos Santos
- Dentistry and Health Postgraduate Program, Dental School, UFBA - Universidade Federal da Bahia, Salvador, BA, Brazil
| |
Collapse
|
45
|
Actinomyces radicidentis and Actinomyces haliotis, coccoid Actinomyces species isolated from the human oral cavity. Anaerobe 2017. [PMID: 28647397 DOI: 10.1016/j.anaerobe.2017.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There are few reports on the bacterial species Actinomyces radicidentis in the literature. In this study, putative A. radicidentis isolates were collected from 16 root canal samples from 601 examined patients. The isolates were examined by biochemical tests, 16S rRNA gene sequencing, Arbitrarily-primed (AP-) PCR, antibiotic susceptibility testing, and MALDI-TOF analyses. In parallel, two A. radicidentis reference strains and two putative A. radicidentis isolates from United Kingdom were tested. Sixteen of the 18 isolates were confirmed as A. radicidentis. The remaining two isolates, both of which were isolated from root canals (one from Sweden and the other from the UK), but were identified as Actinomyces haliotis by sequencing ∼ 1300 base pairs of the 16S rRNA-gene. This isolates had a divergent, but between them similar, AP-PCR pattern, and a common distribution of sequence signatures in the 16S rRNA gene, but were not identified by MALDI-TOF. A. haliotis is a close relative to A. radicidentis, hitherto only been described from a sea-snail. The identity of A. haliotis was confirmed by a phylogenetic tree based on 16S rRNA gene sequences with species specific sequences included, and by additional biochemical tests. The examined bacteria exhibited similar antibiotic susceptibility patterns when tested for 10 separate antibiotic classes with E-tests (bioMérieux). The MIC90 for β-lactams (benzylpenicillin and cefuroxime) and vancomycin was 0.5 mg/L, for colistin and ciprofloxacin 8 mg/mL and for the other antibiotic classes ≤ 25 mg/mL The isolation of A. haliotis from infected dental root canals cast doubt on the accepted opinion that all Actinomyces infections have an endogenous source.
Collapse
|
46
|
Nahum A, Filice G, Malhotra A. A Complicated Thread: Abdominal Actinomycosis in a Young Woman with Crohn Disease. Case Rep Gastroenterol 2017; 11:377-381. [PMID: 28690491 PMCID: PMC5498965 DOI: 10.1159/000475917] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/18/2017] [Indexed: 12/31/2022] Open
Abstract
Crohn disease is a chronic inflammatory condition that primarily affects the gastrointestinal tract. Typical manifestations include fever, weight loss, fatigue, and abdominal pain, and abdominal abscesses and fistulae are frequent complications. Abdominal actinomycosis is a subacute or indolent disease associated with Actinomyces spp. Symptoms can be very similar to those of Crohn disease, and fistulae are also common. Since ulcerations in the intestinal tract are thought to be caused by Actinomyces escaping from the gut lumen and establishing intra-abdominal infection, it seems likely that abdominal actinomycosis may occur in patients with inflammatory bowel disease. We report a case of abdominal actinomycosis in a woman with active Crohn disease.
Collapse
Affiliation(s)
- Ari Nahum
- Minneapolis Veterans Hospital, Minneapolis, Minnesota, USA
| | - Gregory Filice
- Minneapolis Veterans Hospital, Minneapolis, Minnesota, USA
| | | |
Collapse
|
47
|
Bouttefroy S, Faure Conter C, Tristan A, Valour F, Perpoint T, Reix P, Thiesse P, Dijoud F, Catho G. [Disseminated actinomycosis treated with clindamycin]. Arch Pediatr 2017; 24:460-463. [PMID: 28343883 DOI: 10.1016/j.arcped.2017.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 12/08/2016] [Accepted: 02/18/2017] [Indexed: 10/19/2022]
Abstract
Actinomycosis is a rare bacterial disease caused by Actinomyces spp., an anaerobic bacteria from the oropharynx, digestive, and female genital tracts. Initial clinical presentation often mimics malignancy, which can lead to a delay in diagnosis. Cervico-facial, genitourinary, digestive, and respiratory features are the most frequent. Few cases are reported in children and risk factors are not well known in this population. We report on the case of an 8-year-old boy with disseminated actinomycosis with cervico-facial, pulmonary, and bone involvement caused by Actinomyces israelii. The infiltrative appearance initially suggested malignancy and the patient was started on chemotherapy for presumed histiocytosis. Evaluation of subsequent tissue samples demonstrated the presence of filamentous structures consistent with fungal or filamentous bacterial infection. Prolonged culture yielded the correct diagnosis. The patient had a severe allergic reaction to piperacillin/tazobactam and was therefore transitioned to clindamycin to complete a 9-month course. This treatment, which has not been reported in children, led to a favorable clinical, biological, and radiological response, with a good clinical tolerance.
Collapse
Affiliation(s)
- S Bouttefroy
- Service de pneumologie pédiatrique, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France; Institut d'hématologie et d'oncologie pédiatrique, 1, place Joseph-Renault, 69008 Lyon, France.
| | - C Faure Conter
- Institut d'hématologie et d'oncologie pédiatrique, 1, place Joseph-Renault, 69008 Lyon, France
| | - A Tristan
- Centre de pathologie Est, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France
| | - F Valour
- Service de maladies infectieuses et tropicales, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69004 Lyon, France; Inserm U1111, centre international de recherche en infectiologie (CIRI), 46, allée d'Italie, 69364 Lyon cedex, France
| | - T Perpoint
- Service de maladies infectieuses et tropicales, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69004 Lyon, France
| | - P Reix
- Service de pneumologie pédiatrique, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France
| | - P Thiesse
- Centre Léon-Bérard Lyon, 28, rue Laënnec, 69008 Lyon, France
| | - F Dijoud
- Centre de pathologie Est, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France
| | - G Catho
- Service de pneumologie pédiatrique, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69677 Bron cedex, France
| |
Collapse
|
48
|
Lisa-Gracia M, Martín-Rivas B, Pajarón-Guerrero M, Arnáiz-García A. Abdominal actinomycosis in the last 10 years and risk factors for appendiceal actinomycosis: review of the literature. Turk J Med Sci 2017; 47:98-102. [PMID: 28263474 DOI: 10.3906/sag-1511-52] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 05/07/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM Actinomycosis is a granulomatous disease caused by filamentous, gram-positive, anaerobic bacteria. Actinomycetes are commensal inhabitants of the oral cavity and intestinal tract but acquire pathogenicity through invasion of breached or necrotic tissue.1397645907In abdominal actinomycosis (AA), the appendix and ileocecal region are usually involved. The aim of this study was to characterize patients diagnosed with AA and to establish the risk factors for appendiceal actinomycosis, including a short review of the literature. MATERIALS AND METHODS We conducted a prospective cohort study of all patients diagnosed with AA in the University Hospital Marques de Valdecilla (Santander-Cantabria) from January 2003 to October 2013. We also conducted a short review of the literature. RESULTS We characterized the epidemiological features of patients diagnosed with AA and risk factors for the involvement of the appendix, as most of the cases were misdiagnosed as appendicitis. Risk factors for appendiceal actinomycosis are no antecedents of carcinoma (P = 0.034) and previous incorrect diagnosis (P = 0.006). CONCLUSION AA is a rare and chronic infection. It is only reported in case reports in the literature. We present the largest series of patients diagnosed with AA. Half of the patients had morbidities, mostly carcinoma, and penicillin was the preferred treatment. More studies are needed to characterize patients affected with AA and to establish the correct treatment.
Collapse
Affiliation(s)
- Marta Lisa-Gracia
- Department of General Internal Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Berta Martín-Rivas
- Department of General Internal Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Ana Arnáiz-García
- Infectious Diseases Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| |
Collapse
|
49
|
Kim UG, Kim CH, Kwon KS, Hwang E. Actinomycosis in a Mucosal Lesion on a Created Perioral Dimple: A Case Report. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2017. [DOI: 10.14730/aaps.2017.23.3.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ui Geon Kim
- Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Chung Hun Kim
- Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Kyung Suk Kwon
- Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Euna Hwang
- Department of Plastic and Reconstructive Surgery, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| |
Collapse
|
50
|
Sama CB, Mbarga NF, Oben CE, Mbarga JA, Nfor EK, Angwafo Iii FF. Massive paediatric cervicofacial actinomycoses masquerading as an ulcerative malignancy. BMC Infect Dis 2016; 16:417. [PMID: 27526941 PMCID: PMC4986358 DOI: 10.1186/s12879-016-1768-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 08/09/2016] [Indexed: 11/12/2022] Open
Abstract
Background Paediatric cervicofacial actinomycosis is a rare infectious disease caused by Actinomyces spp. and usually presents as a chronic, suppurative and granulomatous inflammation with a propensity to mimic malignant conditions. Case presentation We discuss the case of an 11-year-old African female who presented with a chronic disfiguring cervical mass evolving over a 9 months period for which she had several unyielding consultations. Appropriate clinical and para-clinical evaluations were paramount to the diagnosis of an Actinomyces infection. We review the literature on its epidemiology, clinical presentation, diagnosis, treatment and prognosis. Conclusion Actinomycosis still poses a diagnostic challenge. It is important for clinicians to consider the possibility of such rare infections in apparently malignant looking masses and also in lesions not responding to several antimicrobial treatments. The condition generally carries a good prognosis if recognised early and histopathological diagnosis is the gold standard.
Collapse
Affiliation(s)
- Carlson-Babila Sama
- Islamic Medicalised Health Centre, Babessi, Cameroon and Galactic Corps Research Group (GCRG), Buea, Cameroon.
| | - Nicole Fouda Mbarga
- SporeData Inc., Durham, United States of America and Sangmelima District Hospital, South Region, Cameroon
| | - Calvin Eta Oben
- Islamic Medicalised Health Centre, Babessi, Cameroon and Galactic Corps Research Group (GCRG), Buea, Cameroon.,Community Humanitarian Emergency Board, Bangui, Central African Republic
| | - Jules A Mbarga
- Islamic Medicalised Health Centre, Babessi, Cameroon and Galactic Corps Research Group (GCRG), Buea, Cameroon.,Croix Rouge-Française, Yaoundé, Cameroon
| | | | | |
Collapse
|