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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.
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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.
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Actinomycotic osteomyelitis with proliferative periostitis arising in the mandibular ramus: an unusual case with spontaneous bone regeneration after coronoidectomy. Oral Radiol 2020; 37:137-145. [PMID: 32607939 DOI: 10.1007/s11282-020-00462-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 06/18/2020] [Indexed: 12/27/2022]
Abstract
Actinomycotic osteomyelitis is an aggressive and persistent disease capable of invading and destroying bone, and chronic osteomyelitis with proliferative periostitis represents new bone formation with periosteal reaction. We report a rare case of actinomycotic osteomyelitis with proliferative periostitis arising in the mandibular ramus and spontaneous bone regeneration after coronoidectomy. A 14-year-old girl was referred for swelling in the right parotid-masseteric region and severe trismus. Contrast-enhanced CT revealed that heterogenous enhancement of the right masseter muscle, and a reactive bone formation over the lateral cortex of the right mandibular ramus and osteolysis of the condyle were seen in plain CT. MRI showed that the mandibular ramus was a low-signal intensity and the reactive bone on the ramus was signal intensity similar to muscle on T1-weighted images. The lesion was clinically and radiologically diagnosed as chronic osteomyelitis of the mandibular ramus. However, a biopsy was performed intraorally under general anesthesia to rule out a malignant bone tumor, and pathological examination showed fibrous bone and Actinomyces druses. Finally, the lesion was diagnosed as actinomycotic osteomyelitis with proliferative periostitis. She underwent image-guided intraoral removal of impacted right third molar and reactive proliferative bone on the right mandibular ramus under general anesthesia. To improve trismus, coronoidectomy also was performed. After the discharge, AMPC was administrated intraorally for 7.5 months. Postoperative panoramic radiograph and CT showed the right mandibular angle resorption and coronoid process regeneration. There was no recurrence of mandibular osteomyelitis 7 years after surgery.
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Bortoluzzi P, Nazzaro G, Giacalone S, Veraldi S. Cervicofacial actinomycosis: a report of 14 patients observed at the Dermatology Unit of the University of Milan, Italy. Int J Dermatol 2020; 59:1222-1225. [DOI: 10.1111/ijd.14934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 01/29/2023]
Affiliation(s)
- Paolo Bortoluzzi
- Postgraduate School of Dermatology and Venereology Università degli Studi Milan Italy
| | - Gianluca Nazzaro
- Department of Pathophysiology and Transplantation Università degli Studi IRCCS Foundation Cà Granda Ospedale Maggiore Policlinico Milan Italy
| | - Serena Giacalone
- Postgraduate School of Dermatology and Venereology Università degli Studi Milan Italy
| | - Stefano Veraldi
- Department of Pathophysiology and Transplantation Università degli Studi IRCCS Foundation Cà Granda Ospedale Maggiore Policlinico Milan Italy
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Gupta N, Aggarwal A, Ramteke P, Soneja M. Mandibular osteomyelitis due to Actinomyces spp. BMJ Case Rep 2020; 13:13/5/e235744. [PMID: 32398252 DOI: 10.1136/bcr-2020-235744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Nitin Gupta
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Anivita Aggarwal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Prashant Ramteke
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Manish Soneja
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Suzuki K, Kurihara J, Kim M, Yanagisawa S, Ogawa M, Makiguchi T, Yokoo S. Image screening for maxillo-mandibular actinomycosis with CT, 18F-FDG-PET/CT, and 18F-α-methyl tyrosine PET/CT. Oral Radiol 2020; 37:46-54. [PMID: 31925626 DOI: 10.1007/s11282-020-00421-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 12/31/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Clinical features and imaging findings of maxillo-mandibular actinomycosis are similar to those of intraosseous carcinoma. The purpose of this study is to clarify the characteristics of the imaging findings for screening of maxillo-mandibular actinomycosis using CT and PET. METHODS Reports on maxillo-mandibular actinomycosis published between 1997 and 2016 were searched in PubMed using "actinomycosis," "maxilla," and "mandibular" as keywords. Ten cases suspected to have malignant tumors on diagnostic imaging findings were selected. In addition, three patients who visited Gunma University Hospital were also included. The 13 total cases were subjected to a pooled analysis of diagnostic screening of maxillo-mandibular actinomycosis using CT, 18F-FDG-PET/CT (FDG-PET/CT) and 18F-α-methyl tyrosine PET/CT (FAMT-PET/CT). Additionally, cases of intraosseous carcinoma were analyzed as comparative controls to investigate the difference between maxillo-mandibular actinomycosis and intraosseous carcinoma on CT imaging. RESULTS CT images of the 13 cases with maxillo-mandibular actinomycosis were investigated; spotty-type bone resorption was observed in 66.7% (8/12). Moreover, FDG-PET/CT showed abnormal accumulation, but FAMT-PET/CT showed no apparent abnormal accumulation. CONCLUSIONS Clinical and imaging findings of maxillo-mandibular actinomycosis are similar to those of intraosseous carcinoma. Differential diagnostic screening can confirm spotty-type bone resorption in cortical bone with CT and specific accumulation in malignant tumors with FAMT-PET/CT. This screening facilitates the rapid implementation of therapeutic interventions.
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Affiliation(s)
- Keisuke Suzuki
- Department of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Shouwamachi, Maebashi City, Gunma, 371-8511, Japan.
| | - Jun Kurihara
- Department of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Shouwamachi, Maebashi City, Gunma, 371-8511, Japan
| | - Mai Kim
- Department of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Shouwamachi, Maebashi City, Gunma, 371-8511, Japan.,Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Shouwamachi, Maebashi, 371-8511, Gunma, Japan
| | - Sakura Yanagisawa
- Department of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Shouwamachi, Maebashi City, Gunma, 371-8511, Japan
| | - Masaru Ogawa
- Department of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Shouwamachi, Maebashi City, Gunma, 371-8511, Japan
| | - Takaya Makiguchi
- Department of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Shouwamachi, Maebashi City, Gunma, 371-8511, Japan
| | - Satoshi Yokoo
- Department of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Shouwamachi, Maebashi City, Gunma, 371-8511, Japan
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Bandara HMHN, Samaranayake LP. Viral, bacterial, and fungal infections of the oral mucosa: Types, incidence, predisposing factors, diagnostic algorithms, and management. Periodontol 2000 2019; 80:148-176. [PMID: 31090135 DOI: 10.1111/prd.12273] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
For millions of years, microbiota residing within us, including those in the oral cavity, coexisted in a harmonious symbiotic fashion that provided a quintessential foundation for human health. It is now clear that disruption of such a healthy relationship leading to microbial dysbiosis causes a wide array of infections, ranging from localized, mild, superficial infections to deep, disseminated life-threatening diseases. With recent advances in research, diagnostics, and improved surveillance we are witnessing an array of emerging and re-emerging oral infections and orofacial manifestations of systemic infections. Orofacial infections may cause significant discomfort to the patients and unnecessary economic burden. Thus, the early recognition of such infections is paramount for holistic patient management, and oral clinicians have a critical role in recognizing, diagnosing, managing, and preventing either new or old orofacial infections. This paper aims to provide an update on current understanding of well-established and emerging viral, bacterial, and fungal infections manifesting in the human oral cavity.
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Affiliation(s)
| | - Lakshman P Samaranayake
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE
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Gajdács M, Urbán E, Terhes G. Microbiological and Clinical Aspects of Cervicofacial Actinomyces Infections: An Overview. Dent J (Basel) 2019; 7:dj7030085. [PMID: 31480587 PMCID: PMC6784480 DOI: 10.3390/dj7030085] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 02/07/2023] Open
Abstract
Similarly to other non-spore-forming Gram-positive anaerobes, members of the Actinomyces genus are important saprophytic constituents of the normal microbiota of humans. Actinomyces infections are considered to be rare, with cervicofacial infections (also known as ‘lumpy jaw syndrome’) being the most prevalent type in the clinical practice. Actinomycoses are characterized by a slowly progressing (indolent) infection, with non-specific symptoms, and additionally, the clinical presentation of the signs/symptoms can mimic other pathologies, such as solid tumors, active Mycobacterium tuberculosis infections, nocardiosis, fungal infections, infarctions, and so on. The clinical diagnosis of actinomycosis may be difficult due to its non-specific symptoms and the fastidious, slow-growing nature of the pathogens, requiring an anaerobic atmosphere for primary isolation. Based on 111 references, the aim of this review is to summarize current advances regarding the clinical features, diagnostics, and therapy of cervicofacial Actinomyces infections and act as a paper for dentistry specialists, other physicians, and clinical microbiologists.
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Affiliation(s)
- Márió Gajdács
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Eötvös utca 6., Hungary.
- Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, 6725 Szeged, Semmelweis utca 6., Hungary.
| | - Edit Urbán
- Department of Public Health, Faculty of Medicine, University of Szeged, 6720 Szeged, Dóm tér 10., Hungary
| | - Gabriella Terhes
- Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, 6725 Szeged, Semmelweis utca 6., Hungary
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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.
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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
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Yamamoto S, Takegawa H, Taniike N, Takenobu T. Actinomycotic Osteomyelitis of the Mandible Diagnosed Using Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry: A Case Report. J Oral Maxillofac Surg 2018; 76:2122-2130. [PMID: 29782813 DOI: 10.1016/j.joms.2018.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 02/01/2023]
Abstract
Actinomycosis is a rare, chronic, slowly progressive granulomatous disease caused by filamentous gram-positive anaerobic bacteria from the Actinomycetaceae family (genus Actinomyces). It has become a rare condition because of the widespread use of antibiotics. When clinical symptoms are not typical, diagnosis of this condition becomes difficult. This report describes a case involving an 82-year-old woman who was diagnosed with actinomycotic osteomyelitis of the mandible using matrix assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS). The patient was referred to the authors' department with chief complaints of swelling, multiple fistulae in the left preauricular region, and trismus. The authors performed fine-needle aspiration microbiology (FNAM) and identified Actinomyces oris using MALDI-TOF MS. A diagnosis of actinomycotic osteomyelitis of the mandible was made and the patient was treated with minocycline and extraction of the culprit tooth. The findings from this case have 2 important implications. First, for patients with clinically suspected actinomycosis, bacteriologic examinations should include not only surface swab tests but also FNAM; moreover, communication with the laboratory medical technologist is important to improve detection of the causative organisms. Second, MALDI-TOF MS could be an effective tool for improving the diagnosis and treatment outcomes of actinomycosis.
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Affiliation(s)
- Shinsuke Yamamoto
- Head Physician, Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
| | - Hiroshi Takegawa
- Chief Examiner, Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Naoki Taniike
- Head Physician, Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Toshihiko Takenobu
- Department Head, Department of Oral and Maxillofacial Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
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10
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Reddy BVR, Kuruba KK, Yalamanchili S, Mupparapu M. Granulomatous Diseases Affecting Jaws. Dent Clin North Am 2017; 60:195-234. [PMID: 26614955 DOI: 10.1016/j.cden.2015.08.007] [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: 01/08/2023]
Abstract
The common aspect of all granulomatous diseases is the typical form of chronic inflammatory response with distinct microscopic granulomas that are formed secondary to either definitive etiologic agents, like bacteria, fungal, or parasitic, or due to an unknown etiologic agent, such as trauma, autoimmune, or even neoplastic process. Although they can be histologically distinct, granulomatous diseases demonstrate a variety of clinical features that may not seem to be inflammatory. Two types of granulomas are typically encountered: foreign body granulomas and immune granulomas. The differences between the two types of granulomas lie in the pathogenesis.
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Affiliation(s)
- Baddam Venkat Ramana Reddy
- Department of Oral & Maxillofacial Pathology, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, 522601, India
| | - Kiran K Kuruba
- Department of Oral & Maxillofacial Pathology, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, 522601, India
| | - Samatha Yalamanchili
- Department of Oral Medicine & Radiology, Sibar Institute of Dental Sciences, Guntur, India
| | - Mel Mupparapu
- Department of Oral Medicine, Robert Schattner Center, University of Pennsylvania School of Dental Medicine, #214, 240 South 40th Street, Suite 214, Philadelphia, PA 19104, USA.
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11
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Diagnostic value of computed tomography, magnetic resonance imaging, and scintigraphy in diagnosing actinomycosis of the mandible. Oral Radiol 2016. [DOI: 10.1007/s11282-016-0268-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Eenhuis LL, de Lange ME, Samson AD, Busch ORC. Spontaneous Bacterial Peritonitis due to Actinomyces Mimicking a Perforation of the Proximal Jejunum. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:616-20. [PMID: 27561364 PMCID: PMC5003149 DOI: 10.12659/ajcr.897956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Patient: Female, 42 Final Diagnosis: Spontaneous pelvic-abdominal peritonitis due to actinomyces Symptoms: Abdominal distension • abdominal pain • acute abdomen • fever • intermenstrual bleeding • nausea • sepsis • septic shock Medication: — Clinical Procedure: — Specialty: Surgery
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Affiliation(s)
- Louise L Eenhuis
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Marleen E de Lange
- Department of Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Anda D Samson
- Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Olivier R C Busch
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
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Thayil N, Chapman MN, Saito N, Fujita A, Sakai O. Magnetic Resonance Imaging of Acute Head and Neck Infections. Magn Reson Imaging Clin N Am 2016; 24:345-67. [PMID: 27150323 DOI: 10.1016/j.mric.2015.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This article discusses the use of MR imaging in various acute infectious diseases of the head and neck, with particular emphasis on situations where MR imaging provides additional information that can significantly impact treatment decisions and outcomes. MR imaging findings of various disease processes are discussed, based on the head and neck compartments from which they originate. Specifically, infectious entities of the orbit, paranasal sinuses, pharynx, oral cavity (including periodontal disease), salivary glands, temporal bone, and lymph nodes are described in detail.
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Affiliation(s)
- Neil Thayil
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA 02118, USA
| | - Margaret N Chapman
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA 02118, USA; Radiology Service, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, MA 02132, USA
| | - Naoko Saito
- Department of Radiology, Saitama International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Akifumi Fujita
- Department of Radiology, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Osamu Sakai
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA 02118, USA.
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Boyanova L, Kolarov R, Mateva L, Markovska R, Mitov I. Actinomycosis: a frequently forgotten disease. Future Microbiol 2016; 10:613-28. [PMID: 25865197 DOI: 10.2217/fmb.14.130] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Actinomycosis is a rare subacute or chronic, endogenous infection mainly by Actinomyces species, showing low virulence through fimbriae and biofilms. Cervicofacial, thoracic, abdominal, pelvic and sometimes cerebral, laryngeal, urinary and other regions can be affected. Actinomycosis mimics other diseases, often malignancy. Disease risk in immunocompromised subjects needs clarification. Diagnosis is often delayed and 'sulfur granules' are helpful but nonspecific. Culture requires immediate specimen transport and prolonged anaerobic incubation. Imaging, histology, cytology, matrix-assisted laser desorption ionization time-of-flight mass spectrometry and molecular methods improve the diagnosis. Actinomycetes are β-lactam susceptible, occasionally resistant. Treatment includes surgery and/or long-term parenteral then oral antibiotics, but some 1-4-week regimens or oral therapy alone were curative. For prophylaxis, oral hygiene and regular intrauterine device replacement are important.
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Affiliation(s)
- Lyudmila Boyanova
- Department of Medical Microbiology, Medical University of Sofia, Bulgaria
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15
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Nwawka OK, Nadgir R, Fujita A, Sakai O. Granulomatous disease in the head and neck: developing a differential diagnosis. Radiographics 2015; 34:1240-56. [PMID: 25208278 DOI: 10.1148/rg.345130068] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Granulomatous diseases have a varied etiology that includes autoimmune, infectious, idiopathic, and hereditary causes. The unifying factor in these diseases is the formation of granulomas, which histologically are mononuclear inflammatory cells or macrophages surrounded by lymphocytes. Granulomatous diseases often have systemic manifestations that affect organs throughout the body. Granulomatous diseases with head and neck manifestations include granulomatosis with polyangiitis, Churg-Strauss syndrome, Behçet disease, chronic granulomatous disease, and sarcoidosis. Infectious causes include tuberculosis, cat-scratch disease, syphilis, leprosy, actinomycosis, rhinoscleroma, and fungal infections. In the head and neck, granulomatous disease may affect the orbits, sinonasal cavities, salivary glands, aerodigestive tract, temporal bone, or skull base. Imaging findings include sinonasal opacification, ocular and other soft-tissue masses, osseous erosion, airway narrowing, lymphadenopathy, and salivary gland infiltration. Vascular involvement may also be evident, with displacement, narrowing, or occlusion of arteries and veins. Some radiologic findings of granulomatous processes have a considerable overlap with findings of malignancy, and a radiologic differential diagnosis inclusive of both is critical to avoid incorrect clinical treatment. Without the benefit of a prior clinical diagnosis, laboratory findings, or suggestive clinical signs and symptoms, granulomatous diseases may be difficult to differentiate radiologically. Although individual granulomatous diseases may have overlapping findings at imaging, certain radiologic findings should prompt the inclusion of granulomatous diseases in the differential diagnosis, thus facilitating appropriate clinical management.
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Affiliation(s)
- O Kenechi Nwawka
- From the Departments of Radiology (O.K.N., R.N., A.F., O.S.) and Otolaryngology-Head and Neck Surgery (O.S.), Boston Medical Center, Boston University School of Medicine, 820 Harrison Ave, Boston, MA 02118
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16
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Valour F, Sénéchal A, Dupieux C, Karsenty J, Lustig S, Breton P, Gleizal A, Boussel L, Laurent F, Braun E, Chidiac C, Ader F, Ferry T. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management. Infect Drug Resist 2014; 7:183-97. [PMID: 25045274 PMCID: PMC4094581 DOI: 10.2147/idr.s39601] [Citation(s) in RCA: 248] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. Physicians must be aware of typical clinical presentations (such as cervicofacial actinomycosis following dental focus of infection, pelvic actinomycosis in women with an intrauterine device, and pulmonary actinomycosis in smokers with poor dental hygiene), but also that actinomycosis may mimic the malignancy process in various anatomical sites. Bacterial cultures and pathology are the cornerstone of diagnosis, but particular conditions are required in order to get the correct diagnosis. Prolonged bacterial cultures in anaerobic conditions are necessary to identify the bacterium and typical microscopic findings include necrosis with yellowish sulfur granules and filamentous Gram-positive fungal-like pathogens. Patients with actinomycosis require prolonged (6- to 12-month) high doses (to facilitate the drug penetration in abscess and in infected tissues) of penicillin G or amoxicillin, but the duration of antimicrobial therapy could probably be shortened to 3 months in patients in whom optimal surgical resection of infected tissues has been performed. Preventive measures, such as reduction of alcohol abuse and improvement of dental hygiene, may limit occurrence of pulmonary, cervicofacial, and central nervous system actinomycosis. In women, intrauterine devices must be changed every 5 years in order to limit the occurrence of pelvic actinomycosis.
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Affiliation(s)
- Florent Valour
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France ; Université Claude Bernard Lyon 1, Lyon, France ; Centre International de Recherche en Infectiologie, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Agathe Sénéchal
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France ; Université Claude Bernard Lyon 1, Lyon, France
| | - Céline Dupieux
- Université Claude Bernard Lyon 1, Lyon, France ; Centre International de Recherche en Infectiologie, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France ; Laboratoire de Bactériologie, Centre de Biologie du Nord, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France
| | - Judith Karsenty
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France ; Université Claude Bernard Lyon 1, Lyon, France
| | - Sébastien Lustig
- Université Claude Bernard Lyon 1, Lyon, France ; Chirurgie Orthopédique, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France
| | - Pierre Breton
- Université Claude Bernard Lyon 1, Lyon, France ; Stomatologie et Chirurgie Maxillo-faciale, Hospices Civils de Lyon, Groupement Hospitalier Sud, Lyon, France
| | - Arnaud Gleizal
- Université Claude Bernard Lyon 1, Lyon, France ; Chirurgie Maxillo-faciale, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France
| | - Loïc Boussel
- Université Claude Bernard Lyon 1, Lyon, France ; Radiologie, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France ; Creatis, CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA Lyon, Lyon, France
| | - Frédéric Laurent
- Université Claude Bernard Lyon 1, Lyon, France ; Centre International de Recherche en Infectiologie, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France ; Laboratoire de Bactériologie, Centre de Biologie du Nord, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France
| | - Evelyne Braun
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France
| | - Christian Chidiac
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France ; Université Claude Bernard Lyon 1, Lyon, France ; Centre International de Recherche en Infectiologie, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Florence Ader
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France ; Université Claude Bernard Lyon 1, Lyon, France ; Centre International de Recherche en Infectiologie, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Tristan Ferry
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon, France ; Université Claude Bernard Lyon 1, Lyon, France ; Centre International de Recherche en Infectiologie, CIRI, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
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Abstract
Actinomyces odontolyticus, a component of normal human flora, has been implicated in cervicofacial actinomycosis, which most commonly involves the perimandibular soft tissues and is characterized by slowly progressive abscess and sinus tract formation. Actinomycosis has rarely been reported to involve the larynx, and the imaging findings of laryngeal involvement have not been reported. We present a case of laryngeal actinomycosis with findings on computed tomography, magnetic resonance imaging, and positron emission tomography.
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Affiliation(s)
- Forrester Lensing
- Department of Radiology, Neuroradiology Division (Lensing, Abele, Wiggins, Quigley) and the Department of Otolaryngology-Head and Neck Surgery (Wiggins), University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Travis Abele
- Department of Radiology, Neuroradiology Division (Lensing, Abele, Wiggins, Quigley) and the Department of Otolaryngology-Head and Neck Surgery (Wiggins), University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Richard Wiggins
- Department of Radiology, Neuroradiology Division (Lensing, Abele, Wiggins, Quigley) and the Department of Otolaryngology-Head and Neck Surgery (Wiggins), University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Edward Quigley
- Department of Radiology, Neuroradiology Division (Lensing, Abele, Wiggins, Quigley) and the Department of Otolaryngology-Head and Neck Surgery (Wiggins), University of Utah Health Sciences Center, Salt Lake City, Utah
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