1
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Everett M, Kheraj A, Redfield J, Ahmed NS, Kumar A, Kothadia JP. Spontaneous Bacterial Peritonitis Because of Actinomyces. ACG Case Rep J 2024; 11:e01353. [PMID: 38706452 PMCID: PMC11068148 DOI: 10.14309/crj.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/28/2024] [Indexed: 05/07/2024] Open
Abstract
Actinomycosis is a rare chronic granulomatous disease that manifests with nonspecific symptoms of abdominal pain, anorexia, and weight loss. The disparity in the presentation of this condition presents a tremendous diagnostic challenge. There are few reports of Actinomyces species causing spontaneous bacterial peritonitis without previous localized masses or abscesses have been published. We provide a case of spontaneous bacterial peritonitis secondary to Actinomyces species in a 46-year-old woman with uterine fibroids and a lack of preceding abscess. Although rare, spontaneous bacterial peritonitis because of Actinomyces should be considered in differential in female patients without pre-existing liver disease presenting with spontaneous bacterial peritonitis.
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Affiliation(s)
- Matthew Everett
- The University of Tennessee Health Science Center, College of Medicine, Memphis, TN
| | - Anusha Kheraj
- The University of Tennessee Health Science Center, College of Medicine, Memphis, TN
| | - Jordan Redfield
- Division of Gastroenterology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Nazneen S. Ahmed
- Division of Gastroenterology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Aneel Kumar
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Jiten P. Kothadia
- Division of Gastroenterology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN
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2
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Gao Y, Jhamb S, Hayler R, Trickett C, Kwok A. Actinomyces as a rare cause of appendicitis: a case report. J Surg Case Rep 2024; 2024:rjae195. [PMID: 38572291 PMCID: PMC10984727 DOI: 10.1093/jscr/rjae195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 03/09/2024] [Indexed: 04/05/2024] Open
Abstract
Actinomycosis remains a rare and often underdiagnosed cause of appendicitis with only 10% of cases diagnosed prior to surgery. It is an important cause to consider particularly in the setting of an indolent infection with nonspecific symptoms. We present a 22 years old male who presented with 3 weeks history of lower abdominal pain who underwent laboratory investigations and imaging studies suggestive of acute appendicitis. He underwent an emergency laparoscopic caecectomy with histopathology of the specimen suggestive of actinomycosis. He recovered well postoperatively and was discharged home with a prolonged course of oral penicillins. Preoperative diagnosis of actinomycosis is uncommon and accounts for ~10% of cases. Definitive diagnosis is usually through histopathology or tissue/fluid culture. Treatment usually involves a combination of surgical resection and antibiotic therapy with a success rate of >90%.
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Affiliation(s)
- Yijun Gao
- Department of Surgery, The Sutherland Hospital, The Kingsway, Caringbah 2229, NSW, Australia
| | - Shaurya Jhamb
- Department of Surgery, The Sutherland Hospital, The Kingsway, Caringbah 2229, NSW, Australia
| | - Raymond Hayler
- Department of Surgery, St George Public Hospital, Gray Street, Kogarah 2217, NSW, Australia
| | - Chloe Trickett
- Department of Surgery, The Sutherland Hospital, The Kingsway, Caringbah 2229, NSW, Australia
| | - Allan Kwok
- Department of Surgery, The Sutherland Hospital, The Kingsway, Caringbah 2229, NSW, Australia
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3
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Lesmana A, Wirdhani V, Perangin Angin LBR, Muzakky MI, Hayon SGV, Sholihah MM, Hanif MI. Sigmoid colon pseudotumor of actinomycosis: a rare case. J Surg Case Rep 2024; 2024:rjad697. [PMID: 38186751 PMCID: PMC10766591 DOI: 10.1093/jscr/rjad697] [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] [Received: 06/30/2023] [Accepted: 11/27/2023] [Indexed: 01/09/2024] Open
Abstract
Actinomycosis is a chronic suppurative infection caused by gram-positive bacteria, Actinomyces, which commonly colonize the oral cavity, urogenital tract and gastrointestinal tract. It causes opportunistic infection where the mucosal barrier is compromised and is often misdiagnosed as malignancy. We report a case of a 58-year-old female with severe abdominal pain and a palpable tender mass in the left lower quadrant. Computed tomography scan with contrast showed thickening of the transverse, descending to sigmoid colon wall and intense contrast enhancement resembling colitis with mesenteritis. At laparotomy, we found an adherent mass involving sigmoid colon with adjacent small bowel and peritoneum. We decided to perform adhesiolysis and Hartmann procedure. The culture result was negative, whereas the biopsy of sigmoid colon revealed characteristic sulfur granules of actinomycosis colony. Intravenous antibiotic combination of ceftazidime and metronidazole was administered for 14 days followed by complete resolution of symptoms. Histopathological and bacteriological examinations are keys to diagnose actinomycosis. Patients require long-term antibiotic therapy, but surgery is often required because preoperative diagnosis is difficult. Main novel aspects? We presented the rare case of intra-abdominal actinomycosis in IndonesiaThe case was challenging to diagnose pre-operatively based on physical examination andExploratory laparotomy revealed pseudotumor mimicking advanced stage of colon neoplasm.
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Affiliation(s)
- Andy Lesmana
- Surgery Department, Dr. Sitanala Central Hospital, Tangerang, Indonesia
| | - Vika Wirdhani
- Internal Medicine Department, Dr. Sitanala Central Hospital, Tangerang, Indonesia
| | | | - Muhamad I Muzakky
- Emergency Department, Dr. Sitanala Central Hospital, Tangerang, Indonesia
| | - Stefi G V Hayon
- Emergency Department, Dr. Sitanala Central Hospital, Tangerang, Indonesia
| | - Mentari M Sholihah
- Emergency Department, Dr. Sitanala Central Hospital, Tangerang, Indonesia
| | - Muhammad I Hanif
- Emergency Department, Badau Primary Health Care, Kapuas Hulu, Indonesia
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4
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McKeever C, Jayasankar B, Mathew Simon N, Abdul Aal Y, Papadopoulos A. Intra-Abdominal Actinomycosis: An Indolent Masquerader of Malignancy. Cureus 2023; 15:e50215. [PMID: 38192946 PMCID: PMC10772936 DOI: 10.7759/cureus.50215] [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: 12/07/2023] [Indexed: 01/10/2024] Open
Abstract
This report describes the case of a 54-year-old female who presented with the constitutional symptoms of lethargy, weight loss, and asthenia. She had been extensively investigated for possible gynaecological malignancy but with no definitive outcome achieved. The symptoms were persistent and, partly due to occurring during the coronavirus disease 2019 (COVID-19) pandemic, a decision was made to progress with surgical management. Following an oncology multidisciplinary meeting, a decision was made for a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Intra-operatively, there was an incidental finding of an extensive tumour infiltrating the liver, colon, anterior abdominal wall and urinary bladder. A surgical resection with ileostomy was performed on suspicion of an underlying malignancy. Unexpectedly, the histopathological diagnosis revealed actinomycosis. Following this discovery, our entire management plan was altered, and the patient was treated with a prolonged course of antibiotics and recovered well.
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Affiliation(s)
- Catherine McKeever
- General Surgery, North West Anglia NHS Foundation Trust, Huntingdon, GBR
| | - Balaji Jayasankar
- General Surgery, North West Anglia NHS Foundation Trust, Huntingdon, GBR
| | | | - Yasser Abdul Aal
- Surgery, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, GBR
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5
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Ioannidis O, Symeonidis S, Ouzounidis N, Foutsitzis V, Anestiadou E, Christidis P, Loutzidou L, Fesatidou V, Kerasidou O, Tsalis K, Aggelopoulos S. Two case reports of mesenteric and retroperitoneal actinomycosis and a narrative review of the relevant literature. Med Pharm Rep 2023; 96:441-446. [PMID: 37970198 PMCID: PMC10642741 DOI: 10.15386/mpr-2073] [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: 02/09/2021] [Revised: 11/13/2022] [Accepted: 01/22/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction Actinomycosis is an uncommon subacute or chronic suppurative bacterial granulomatous infectious disease with clinical heterogeneity. The majority of actinomycosis cases were of extra-abdominal origin, with oro-cervico-facial cases representing 55%, abdominopelvic representing 20%, and thoracic representing 15% of total reports. Currently, abdominal actinomycosis incidence is approximately 1 case per 119,000 people, being found three times more frequently among males. We report two rare clinical presentations of abdominal actinomycosis affecting the mesentery and the retroperitoneum, respectively. Case Report 1 A 58-year-old Caucasian male presented to our clinic with abdominal pain in the right upper quadrant. Pre-operative evaluation, although inconclusive, showed a mesocolic mass infiltrating the right and transverse colon. The patient underwent exploratory laparotomy. After partial resection of the mass, the histopathology report demonstrated mesenteric actinomycosis. Case Report 2 A 40-year-old Caucasian male presented to our clinic complaining about a mucopurulent material from an orifice at the right inguinal region. After appropriate work-up, a large abdominopelvic, stellate mass (75 x 22.8 mm) in the retroperitoneum was revealed. Surgery along with the appropriate antibiotics was used to treat the patient. Conclusion Preoperative suspicion and diagnosis of actinomycosis are very challenging, with a high rate of misdiagnosis often resulting in delayed treatment. Our case reports highlight that abdominal actinomycosis should always be part of differential diagnosis, especially when there is involvement of multiple organs. The gold standard treatment of actinomycosis is surgical excision with prolonged antibiotic treatment.
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Affiliation(s)
- Orestis Ioannidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Savvas Symeonidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Nikolaos Ouzounidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Vasilis Foutsitzis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Elissavet Anestiadou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Panagiotis Christidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Lydia Loutzidou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Vasiliki Fesatidou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Ourania Kerasidou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Tsalis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Stamatios Aggelopoulos
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
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6
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Kim HG, Lee HK, Park E. Abdominal Actinomycotic Abscess after Laparoscopic Sleeve Gastrectomy for Morbid Obesity: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1516. [PMID: 37763634 PMCID: PMC10534873 DOI: 10.3390/medicina59091516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/11/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023]
Abstract
Actinomycosis is a rare, chronic, suppurative, and granulomatous bacterial disease. The Actinomyces species exist as normal flora in the oropharynx, gastrointestinal tract, and the female genital tract. They are incapable of penetrating the normal mucous membranes and become pathogenic only when this barrier has been destroyed by trauma, surgery, immunosuppression, or after viscus perforation. We report the first case of an actinomycotic abscess after laparoscopic sleeve gastrectomy. A 29-year-old man underwent a laparoscopic sleeve gastrectomy with no intra-operative complications. On postoperative day 3, the patient had a fever with elevated inflammatory markers. Abdominal computerized tomography (CT) with oral water-soluble contrast media showed no extra-luminal leakage and no fluid collection adjacent to the resected stomach, other than the fluid collection in the right subhepatic space. Percutaneous drainage was attempted, but the procedure failed due to the patient's thick abdominal wall. After two weeks of weight loss of about 12 kg, percutaneous drainage was successfully performed, and A. odontolyticus was identified through pus culture. After effective abscess drainage and high-dose antibiotics, the patient's symptoms improved and the abscess pocket disappeared. We reported Actinomyces infection after gastric sleeve surgery. In the case of abscess formation after gastric sleeve surgery caused by actinomycete infection, antibiotic treatment and percutaneous drainage are effective together.
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Affiliation(s)
- Ho-Goon Kim
- Department of General Surgery, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju 61469, Republic of Korea;
| | - Ho-Kyun Lee
- Department of General Surgery, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju 61469, Republic of Korea;
| | - Eunkyu Park
- Department of General Surgery, Chonnam National University Hospital, 42, Jebong-ro, Dong-gu, Gwangju 61469, Republic of Korea
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7
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Abdominopelvic Actinomycosis—The Diagnostic and Therapeutic Challenge of the Most Misdiagnosed Disease. Life (Basel) 2022; 12:life12030447. [PMID: 35330198 PMCID: PMC8954618 DOI: 10.3390/life12030447] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Abdominopelvic actinomycosis is a rare chronic or subacute bacterial infection caused by Actinomyces israelii, a Gram-positive anaerobic bacterium that normally colonizes the digestive and genital tracts, clinically presented as an inflammatory mass or abscess formation. Methods: We reviewed the medical records of the patients from our clinic with abdominopelvic actinomycosis who underwent surgery between 2002 and 2022. In this period, 28 cases (9 men and 19 women) were treated. The mean age was 43.36 years and they were hospitalized for abdominopelvic tumors or inflammatory tumors in 15 cases and inflammatory disease in 13 cases. Results: Causes of actinomycosis in the studied group were an intra-uterine contraceptive device in 17 cases, foreign bodies in 2 cases, diabetes in 4 cases, stenting of the bile duct in 1 case, and immunodepression. For 6 patients, we performed surgery by open approach and for 21 patients by a laparoscopic approach. For nine patients, abdominopelvic actinomycosis had been mimicking a colon malignancy (cecum and ascending colon, four cases; transverse colon, two cases; and on the greater omentum, three cases) and for six patients, a pelvic tumor (advanced ovarian cancer). After surgery the patients underwent specific treatment with antibiotics, with good results. In two cases we discovered and treated hepatic actinomycosis, one case by a laparoscopic approach and one case by a percutaneous approach. In our lot we noticed three recurrences that required reintervention in patients who had had short-term antibiotics due to non-compliance with treatment out of four such cases. Conclusions: For abdominopelvic malignancies, actinomycosis should be included in the differential diagnosis, as well as for inflammatory bowel diseases and bowel obstructions. We have a wide range of patients considering the rarity of this condition. Long-term antibiotics are necessary to prevent recurrence.
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8
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Cronin EA. Actinomycosis: a case report of two patients treated for the condition who required stoma formation. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:S32-S37. [PMID: 34514833 DOI: 10.12968/bjon.2021.30.16.s32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Actinomycosis is a rare bacterial condition that is seen infrequently and no studies have examined its prevalence or incidence globally. The author, a stoma care clinical nurse specialist (CNS), found herself caring for two such patients 3 weeks apart, both of whom were diagnosed with pelvic actinomycosis. Both patients had been fitted with copper intrauterine devices (IUDs) 10 years previously and were not aware that leaving IUDs in situ for a prolonged period increased their risk of infection. This article gives an overview of the condition, with discussion around the two patients the author cared for within her own specialty; not all aspects of the condition are included as the she has no clinical experience in microbiology and is not a gynaecological CNS. The case studies show how both women presented and were treated, with interventions including emergency surgery, long-term antibiotic therapy and stoma formation. Pelvic actinomycosis is often associated with the use of an IUD, and greater awareness about the risk of leaving IUDs in situ for prolonged periods is needed among gastrointestinal, colorectal and gynaecological practitioners.
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Affiliation(s)
- Elaine Anne Cronin
- Stoma Care Clinical Nurse Specialist, Whittington Health NHS Trust, London
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9
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Jabi R, Ramdani H, Elmir S, Elmejjati F, Serji B, El Harroudi T, Bouziane M. Pseudotumoral Actinomycosis Mimicking Malignant Colic Disease: A Case Report and Literature Review. Visc Med 2020; 36:333-337. [PMID: 33005660 DOI: 10.1159/000502895] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 08/22/2019] [Indexed: 01/16/2023] Open
Abstract
Abdominal actinomycosis is a rare, chronic, and often unrecognized suppurative disease. It is caused by an anaerobic gram-positive bacterium, most commonly Actinomyces israeli. Colonic actinomycosis is rarely reported and may be responsible for a pseudotumoral syndrome leading, in the suspicion of malignancy, to a large and mutilating excisional surgery. It is usually the histopathological examination of the surgical specimens that accurately corrects the diagnosis. Here, we report a rare case of a colic actinomycotic involvement taking a pseudotumoral form. The diagnosis was made based on the pathological examination of the surgical piece. Intravenous and then adjuvant oral penicillin G treatment has allowed a favorable clinical evolution. This observation illustrates the preoperative diagnostic difficulties of this rare disease.
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Affiliation(s)
- Rachid Jabi
- General Surgery Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Hanae Ramdani
- Radiology Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Siham Elmir
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Fouad Elmejjati
- Radiotherapy Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Badr Serji
- General Surgery Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Tijani El Harroudi
- General Surgery Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
| | - Mohammed Bouziane
- General Surgery Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, Morocco
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10
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Jones P, Ho C, Juliebø SØ, Hawary A. Pelvic actinomycosis: a forgotten cause of pelvic pain. Br J Hosp Med (Lond) 2020; 81:1-8. [PMID: 33135910 DOI: 10.12968/hmed.2020.0190] [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] [Indexed: 11/11/2022]
Abstract
Actinomycosis is an invasive and suppurative anaerobic infection, which can develop in the pelvis. This occurs most commonly as a result of prolonged use of an intrauterine device. The constellation of signs and symptoms associated with its typical clinical presentation include palpable mass, weight loss and malaise. It can be misdiagnosed as a result and often as a malignant process. Left unrecognised, pelvic actinomycosis can lead to sequelae such as severe abscess, fistula formation and even infertility. Removal of the intrauterine device and a prolonged course (6-12 months) of antibiotic treatment form the cornerstone of management. Surgery can be required in select cases. This article provides an overview of pelvic actinomycosis, including its background, presentation, investigations and management.
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Affiliation(s)
- Patrick Jones
- Department of Urology, Great Western Hospital, Swindon, UK
| | - Cherrie Ho
- Department of Urology, Great Western Hospital, Swindon, UK
| | | | - Amr Hawary
- Department of Urology, Great Western Hospital, Swindon, UK
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11
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Agrawal A, Huang KG. A Uterine Actinomycosis with Extensive Pelvic Involvement. J Gynecol Surg 2020. [DOI: 10.1089/gyn.2020.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ajay Agrawal
- Department of Obstetrics and Gynecology, B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Kuan-Gen Huang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
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12
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Manterola C, Grande L, Riffo‐Campos ÁL, Salgado C, Otzen T. Clinical aspects of abdominal actinomycosis: a systematic review. ANZ J Surg 2020; 90:1465-1468. [DOI: 10.1111/ans.16141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Carlos Manterola
- Department of SurgeryUniversidad de La Frontera Temuco Chile
- Center of Excellence in Morphological and Surgical Studies (CEMyQ)Universidad de La Frontera Temuco Chile
- PhD Program in Medical SciencesUniversidad de La Frontera Temuco Chile
| | - Luis Grande
- Department of SurgeryHospital del Mar/Institut Hospital del Mar d'Investigacions Mèdiques Barcelona Spain
- Department of SurgeryUniversitat Autònoma de Barcelona Barcelona Spain
| | | | - Carla Salgado
- Department of MedicineUniversidad del Azuay Cuenca Ecuador
| | - Tamara Otzen
- Center of Excellence in Morphological and Surgical Studies (CEMyQ)Universidad de La Frontera Temuco Chile
- PhD Program in Medical SciencesUniversidad de La Frontera Temuco Chile
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13
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Monteiro EVE, Gaspar J, Paiva C, Correia R, Valente V, Coelho A, Lamas NJ. Abdominal Actinomycosis misdiagnosed as liposarcoma. AUTOPSY AND CASE REPORTS 2020; 10:e2020137. [PMID: 32039066 PMCID: PMC6945302 DOI: 10.4322/acr.2020.137] [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: 09/23/2019] [Accepted: 11/13/2019] [Indexed: 01/22/2023] Open
Abstract
Actinomycosis is an uncommon, endogenous, and chronic infection with varied and nonspecific clinical features such as abdominal, pelvic or cervical masses, ulcerative lesions, abscesses, draining fistula, fibrosis, and constitutional symptoms. The disease ensues when the bacteria disrupt the mucosal barrier, invade, and spread throughout interfascial planes. Currently, the diagnosis of actinomycosis is challenging because of its very low frequency and depending on the clinical presentation it may masquerade malignancies. Therapy consists initially in intravenous penicillin, followed by an oral regimen that may be extended until a year of treatment. A timely diagnosis is crucial to avoid extensive therapeutic attempt as surgery. However, a biopsy or drainage of abscesses and fistula’s tract may be required not only as a diagnostic procedure as part of the therapy. We report the case of a 72-year-old woman with an abdominal mass initially misdiagnosed as a liposarcoma. A second biopsy of a skin lesion of the abdominal wall made the diagnosis of actinomycosis, avoiding a major surgical procedure. The patient was treated with a long-term course of antibiotics with favorable outcome. Liposarcoma was ruled out after the patient’s full recovery with antibiotics and the misdiagnosis was credit to the overconfidence on the immunohistochemical positivity to MDM2.
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Affiliation(s)
| | - Joana Gaspar
- Centro Hospitalar Universitário do Porto, Serviço de Cirurgia Geral. Porto, Portugal
| | - Claudia Paiva
- Centro Hospitalar Universitário do Porto, Serviço de Cirurgia Geral. Porto, Portugal
| | - Raquel Correia
- Centro Hospitalar Universitário do Porto, Serviço de Cirurgia Geral. Porto, Portugal
| | - Vitor Valente
- Centro Hospitalar Universitário do Porto, Serviço de Cirurgia Geral. Porto, Portugal
| | - André Coelho
- Centro Hospitalar e Universitário do Porto, Serviço de Anatomia Patológica. Porto, Portugal
| | - Nuno Jorge Lamas
- Centro Hospitalar e Universitário do Porto, Serviço de Anatomia Patológica. Porto, Portugal.,Universidade do Minho, Escola de Medicina, Instituto de Investigação em Ciências da Vida e Saúde (ICVS). Braga, Portugal.,Laboratório associado ICVS/3B's. Braga/Guimarães, Portugal
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14
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Kim S, Kang SI, Kim S, Jang MH, Kim JH. Abdominopelvic Actinomycosis Mimicking Peritoneal Carcinomatosis: A Case Report. Ann Coloproctol 2019; 36:417-420. [PMID: 32054258 PMCID: PMC7837399 DOI: 10.3393/ac.2019.11.07] [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: 10/01/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022] Open
Abstract
Actinomycosis is a rare chronic bacterial infection primarily caused by Actinomyces israelii. A 47-year-old woman presented to our clinic with a 1-week history of lower abdominal pain. Preoperative imaging studies revealed multiple peritoneal and pelvic masses suggestive of malignancy. The primary tumor could not be identified despite further endoscopic and gynecological evaluation. On exploration for tissue confirmation, excisional biopsies from multiple masses were performed because complete excision was not possible. Histopathological examination confirmed actinomycosis with multiple abscesses, and the patient was treated with antibiotics. We present a case of disseminated peritoneal actinomycosis that mimicked malignant peritoneal carcinomatosis on imaging studies.
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Affiliation(s)
- Sungjin Kim
- Department of Surgery, Yeungnam University Medical Center, Daegu, Korea
| | - Sung Il Kang
- Department of Surgery, Yeungnam University Medical Center, Daegu, Korea
| | - Sohyun Kim
- Department of Surgery, Yeungnam University Medical Center, Daegu, Korea
| | - Min Hye Jang
- Department of Pathology, Yeungnam University Medical Center, Daegu, Korea
| | - Jae Hwang Kim
- Department of Surgery, Yeungnam University Medical Center, Daegu, Korea
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15
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Balakrishnan M, Phan YC, McIlroy B, Leung E. "Fungating" tumour? No, it's bacterial! BMJ Case Rep 2019; 12:12/2/e227876. [PMID: 30804160 DOI: 10.1136/bcr-2018-227876] [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: 11/03/2022] Open
Abstract
A fit and healthy 26-year-old woman presented to the general surgical team with epigastric pain and weight loss of 2 stones over 6 months. She has also a positive family history of ulcerative colitis. As her oesophagogastroduodenoscopy and colonoscopy were normal, a contrasted CT was requested, and it detected an inflammatory mass with fat streaking around her transverse colon. An intrauterine contraceptive device (IUCD) was noted. In light of the CT findings, she underwent a diagnostic laparoscopy. As the inflammatory mass was not separable from the transverse colon, a segmental transverse colectomy was proceeded. The histology revealed multiple actinomycosis abscesses in the mesentery. Subsequently, we learnt that her IUCD had been in situ for the last 7 years, and the source of actinomycosis abscesses is likely from her IUCD. The patient was recommended to have the coil removed and commenced on a 6 months course of amoxicillin.
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Affiliation(s)
| | - Yih Chyn Phan
- County Hospital Hereford, Hereford, UK.,College of Medicine and Veterinary Medicine, Edinburgh Medical school, The University of Edinburgh, Edinburgh, UK
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Pelvic Actinomycosis. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2017; 2017:9428650. [PMID: 28684963 PMCID: PMC5480022 DOI: 10.1155/2017/9428650] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 04/05/2017] [Indexed: 12/04/2022]
Abstract
Introduction Actinomycosis is a chronic bacterial infection caused by Actinomyces, Gram-positive anaerobic bacteria. Its symptomatology imitates some malignant pelvic tumours, tuberculosis, or nocardiosis, causing abscesses and fistulas. Actinomycoses are opportunistic infections and require normal mucous barriers to be altered. No epidemiological studies have been conducted to determine prevalence or incidence of such infections. Objective To analyse the clinical cases of pelvic actinomycosis reported worldwide, to update the information about the disease. Methods A systematic review of worldwide pelvic actinomycosis cases between 1980 and 2014 was performed, utilising the PubMed, Scopus, and Google Scholar databases. The following information was analysed: year, country, type of study, number of cases, use of intrauterine device (IUD), final and initial diagnosis, and method of diagnosis. Results 63 articles met the search criteria, of which 55 reported clinical cases and 8 reported cross-sectional studies. Conclusions Pelvic actinomycosis is confusing to diagnose and should be considered in the differential diagnosis of pelvic chronic inflammatory lesions. It is commonly diagnosed through a histological report, obtained after a surgery subsequent to an erroneous initial diagnosis. A bacterial culture in anaerobic medium could be useful for the diagnosis but requires a controlled technique and should be performed using specialised equipment.
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García-García A, Coronel-Martínez J, Leon DCD, Romero-Figueroa MDS, Caballero-Pantoja YE, Manzanares-Leal GL, Rodriguez-Morales M, Sandoval-Trujillo H, Ramírez-Durán N. Detection of Actinomyces spp. in cervical exudates from women with cervical intraepithelial neoplasia or cervical cancer. J Med Microbiol 2017; 66:706-712. [DOI: 10.1099/jmm.0.000485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Alejandra García-García
- Laboratory of Medical and Environmental Microbiology, Department of Medicine, Autonomous University of the State of Mexico, Toluca 50180, Mexico
| | - Jaime Coronel-Martínez
- Division of Clinical Research, Instituto Nacional deCancerología (INCan), SS, Mexico City, Mexico
| | - David Cantú-de Leon
- Division of Clinical Research, Instituto Nacional deCancerología (INCan), SS, Mexico City, Mexico
| | - María del Socorro Romero-Figueroa
- Coordination of Health Research State of Mexico (West Regional Delegation), Instituto Mexicano del Seguro Social, State of Mexico, Mexico
| | | | - Gauddy Lizeth Manzanares-Leal
- Laboratory of Medical and Environmental Microbiology, Department of Medicine, Autonomous University of the State of Mexico, Toluca 50180, Mexico
| | - Miguel Rodriguez-Morales
- Division of Clinical Research, Instituto Nacional deCancerología (INCan), SS, Mexico City, Mexico
| | | | - Ninfa Ramírez-Durán
- Laboratory of Medical and Environmental Microbiology, Department of Medicine, Autonomous University of the State of Mexico, Toluca 50180, Mexico
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Abstract
Abdominal actinomycosis is an uncommon pediatric infection that often manifests with a tumor-like lesion. We describe a previously healthy 11-year-old girl who presented with right lower quadrant abdominal pain and drainage. Computed tomography scan showed an abdominal wall mass. Surgical debridement cultures grew Actinomyces meyeri. Literature review identified 18 additional pediatric cases since 1964 that we have summarized.
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Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease. Case Rep Infect Dis 2017; 2017:1972023. [PMID: 28299215 PMCID: PMC5337322 DOI: 10.1155/2017/1972023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/23/2017] [Indexed: 11/18/2022] Open
Abstract
Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms.
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Castañeda S, Valero JJ, Mosquera E. Primary omental actinomycosis as a differential diagnosis of acute appendicitis in children. Case report. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Abstract
Fish bone foreign body (FFB) is the most frequent food-associated foreign body (FB) in adults, especially in Asia, versus meat in Western countries. The esophageal sphincter is the most common lodging site. Esophageal FB disease tends to occur more frequently in men than in women. The first diagnostic method is laryngoscopic examination. Because simple radiography of the neck has low sensitivity, if perforation or severe complications requiring surgery are expected, computed tomography should be used. The risk factors associated with poor prognosis are long time lapse after FB involvement, bone type, and longer FB (>3 cm). Bleeding and perforation are more common in FFB disease than in other FB diseases. Esophageal FB disease requires urgent treatment within 24 hours. However, FFB disease needs emergent treatment, preferably within 2 hours, and definitely within 6 hours. Esophageal FFB disease usually occurs at the physiological stricture of the esophagus. The aortic arch eminence is the second physiological stricture. If the FB penetrates the esophageal wall, a life-threatening aortoesophageal fistula can develop. Therefore, it is better to consult a thoracic surgeon prior to endoscopic removal.
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Affiliation(s)
- Heung Up Kim
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
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22
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Pelvic Actinomycosis Simulating a Malignant Neoplasm: Case Report and Review of the Literature. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2015. [DOI: 10.1007/s40944-015-0022-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Akbulut S, Yagmur Y, Gumus S, Sogutcu N, Demircan F. Actinomyces-induced inflammatory myofibroblastic tumor of the colon: A rare cause of an abdominal mass: Akbulut et al. inflammatory myofibroblastictumor due to actinomyces spp. Int J Surg Case Rep 2015; 9:15-8. [PMID: 25704558 PMCID: PMC4392327 DOI: 10.1016/j.ijscr.2015.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/06/2015] [Accepted: 02/07/2015] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Inflammatory myofibroblastic tumors (IMFTs) are neoplastic lesions that are either benign or have low-grade malignancy potential. Although the etiopathogenesis is not entirely clear, many factors play a role in their development, including trauma, autoimmune disorders, and infectious and inflammatory processes. However, IMFTs caused by Actinomyces spp. infection are rare, with a limited number of cases reported in the literature. PRESENTATION OF CASE A 30-year-old woman was admitted to our clinic with abdominal pain and a palpable abdominal mass. Contrast-enhanced computed tomography revealed a tumoral lesion (11×10×7cm) in the right colon. A right hemicolectomy and ileocolic anastomosis were performed, during which almost complete obstruction of the lumen by the 7.5×7.0×5.0cm tumor was observed. Histopathology and immunohistochemical findings revealed that the tumor was consistent with an IMFT that developed from an Actinomyces infection. The patient was then placed on amoxicillin and doxycycline therapy. CONCLUSION This case demonstrates that the development of IMFT secondary to actinomycosis is difficult to predict in the preoperative period. Once an exact diagnosis is confirmed by histopathologic examination, affected patients should receive prolonged antibiotherapy.
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Affiliation(s)
- Sami Akbulut
- Department of Surgery, Diyarbakir Education and Research Hospital, 21400 Diyarbakir, Turkey.
| | - Yusuf Yagmur
- Department of Surgery, Diyarbakir Education and Research Hospital, 21400 Diyarbakir, Turkey
| | - Serdar Gumus
- Department of Surgery, Diyarbakir Education and Research Hospital, 21400 Diyarbakir, Turkey
| | - Nilgun Sogutcu
- Department of Surgery, Diyarbakir Education and Research Hospital, 21400 Diyarbakir, Turkey
| | - Firat Demircan
- Department of Surgery, Diyarbakir Education and Research Hospital, 21400 Diyarbakir, Turkey
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Pierre I, Zarrouk V, Noussair L, Molina JM, Fantin B. Invasive actinomycosis: surrogate marker of a poor prognosis in immunocompromised patients. Int J Infect Dis 2014; 29:74-9. [PMID: 25449239 DOI: 10.1016/j.ijid.2014.06.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 06/12/2014] [Accepted: 06/13/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Actinomycosis is a rare disease favored by disruption of the mucosal barrier. In order to investigate the impact of immunosuppression on outcome we analyzed the most severe cases observed in patients hospitalized in three tertiary care centers. METHODS We reviewed all cases of proven invasive actinomycosis occurring over a 12-year period (1997 to 2009) in three teaching hospitals in the Paris area. RESULTS Thirty-three patients (16 male) were identified as having an invasive actinomycosis requiring hospitalization. The diagnosis was made by microbiological identification in 26 patients, pathological examination in eight patients, and by both methods in one. Twenty patients (61%) were immunocompromised. Actinomycosis localization was abdominal or pelvic in 17 patients, thoracic in 11, cervicofacial in three, and neurological in two. Twenty patients (61%) underwent surgery. All strains were susceptible to amoxicillin. All patients were treated with a beta-lactam antibiotic, for a median length of 82 days. Twenty-eight patients (85%) were considered as cured. Overall mortality at hospital discharge was 21% (7/33). Mortality was higher in immunocompromised patients (7/20; 21%) compared to non-immunocompromised patients (0/13) (p=0.027). However, six of seven deaths were directly related to the underlying disease. CONCLUSIONS Actinomycosis is a cause of severe infection in immunocompromised patients and a surrogate marker of a poor prognosis in this specific population.
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Affiliation(s)
- Isabelle Pierre
- Service de Médecine Interne, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, 100 boulevard du général Leclerc, 92110 Clichy, France
| | - Virginie Zarrouk
- Service de Médecine Interne, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, 100 boulevard du général Leclerc, 92110 Clichy, France
| | - Latifa Noussair
- Service de Microbiologie, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Clichy, France
| | - Jean-Michel Molina
- Service de Maladies Infectieuses et Tropicales, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, Paris, France
| | - Bruno Fantin
- Service de Médecine Interne, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, 100 boulevard du général Leclerc, 92110 Clichy, France; Université Paris-Diderot, Sorbonne Paris Cité, Paris, France.
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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: 260] [Impact Index Per Article: 26.0] [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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Blanco-Vela C, Luna-Ayala V, Perez-Aguirre J. Colonic mass secondary to actinomycosis: A case report and literature review. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2014. [DOI: 10.1016/j.rgmxen.2014.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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[Colonic mass secondary to actinomycosis: a case report and literature review]. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2014; 79:206-8. [PMID: 24880530 DOI: 10.1016/j.rgmx.2014.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 03/04/2014] [Accepted: 04/02/2014] [Indexed: 11/24/2022]
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Kim SY, Lee SK, Moon SB. Abdominal actinomycosis complicated by delayed splenic abscess. Surg Infect (Larchmt) 2014; 15:662-4. [PMID: 24841485 DOI: 10.1089/sur.2013.151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Song-Yi Kim
- 1 Department of Surgery, Kangwon National University School of Medicine , Chuncheon, South Korea
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Abstract
Mesenteric tumors are rare and consist of a heterogeneous group of lesions. Masses may arise from any of the mesenteric components: peritoneum, lymphatic tissue, fat, and connective tissue. Cellular proliferation can also arise from infectious or inflammatory processes. They can be classified as solid or cystic, benign or malignant. Mesenteric tumors are usually discovered incidentally or during investigation of non-specific symptoms. While clinical examination and imagery may suffice to make the diagnosis, histopathology is often required by either needle percutaneous or surgical biopsy, or immediate excision. Therapeutic management options vary widely depending on the nature of the lesion; they range from simple observation or medical therapy to surgery. Benign well-delineated mesenteric masses that are symptomatic can often be treated by simple enucleation. But invasive malignant tumors require a carcinologic resection; a careful preoperative evaluation to assess the relationship between the mass and adjacent vascular and digestive structures is essential since they may dictate the need for extensive sacrifice of bowel with resultant intestinal insufficiency due to short bowel syndrome.
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