1
|
Yokoyama S, Hashimoto S, Nishibori S, Hamada H, Nui A, Kimura S. Successful Antimicrobial Therapy of Esophageal Stenosis Because of Actinomycosis. Pediatrics 2024; 153:e2023062823. [PMID: 38655638 DOI: 10.1542/peds.2023-062823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 04/26/2024] Open
Abstract
Esophageal stenosis can cause vomiting or dysphagia in children and is commonly treated with esophageal balloon dilation. However, surgery may be required if the stenosis does not respond to dilation. Although esophageal actinomycosis can cause severe esophageal strictures and be refractory to balloon dilation, it has been reported to respond effectively to antimicrobial therapy in adults. However, the course of the disease and appropriate treatment strategies in children are not well understood. We present a case of a previously healthy 2-year-old boy diagnosed with esophageal stenosis because of actinomycosis. The patient was treated with intravenous penicillin G, followed by oral amoxicillin for 8 weeks and 6 months, respectively. After completion of the antimicrobial treatment, the patient showed improvement in symptoms and endoscopic findings. At the 1-year follow-up, the patient showed consistent weight gain and normal growth without further intervention. This case highlights the importance of considering esophageal actinomycosis as a potential cause of esophageal stenosis in children and the potential effectiveness of antimicrobial therapy in avoiding surgical intervention.
Collapse
Affiliation(s)
| | | | | | | | | | - Sachiko Kimura
- Diagnostic Pathology, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan
| |
Collapse
|
2
|
Karube D, Kamiya K, Sugihara N, Maekawa T, Komine M, Ohtsuki M. A case of bilateral dacryocystitis caused by Streptococcus constellatus and Actinomyces israelii. J Dermatol 2024; 51:e135-e136. [PMID: 37997462 DOI: 10.1111/1346-8138.17041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/15/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023]
Affiliation(s)
- Daiki Karube
- Department of Dermatology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Koji Kamiya
- Department of Dermatology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Natsuko Sugihara
- Department of Dermatology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Takeo Maekawa
- Department of Dermatology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Mayumi Komine
- Department of Dermatology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Mamitaro Ohtsuki
- Department of Dermatology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| |
Collapse
|
3
|
Liao CH, Wu TY, Lin YL, Liu WD, Wang JT, Chen JS, Ho YL. Case Report: Pericardial Actinomycosis in a 79-Year-Old Man with Poor Dental Hygiene. Am J Trop Med Hyg 2024; 110:504-508. [PMID: 38295417 PMCID: PMC10919186 DOI: 10.4269/ajtmh.23-0618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/27/2023] [Indexed: 02/02/2024] Open
Abstract
Actinomycosis is an uncommon infection caused by Actinomyces species, and the diagnosis is often challenging owing to low prevalence and diverse clinical manifestations. Pericardial involvement of actinomycosis is particularly rare. Here, we present a case of a 79-year-old man who initially complained of exertional dyspnea, orthopnea, and decreased urine amount. There was no fever, chest pain, or productive cough. Physical examination was remarkable for decreased breath sounds at the left lower lung field. Poor dental hygiene and a firm, well-defined mass without discharge over the hard palate were noted. Echocardiography revealed reduced ejection fraction of the left ventricle, global hypokinesia, and thickened pericardium (> 5 mm) with a small amount of pericardial effusion. On admission, the patient underwent diagnostic thoracentesis, and the results suggested an exudate. However, bacterial and fungal cultures were all negative. There was no malignant cell by cytology. Computed tomography revealed contrast-enhanced pericardial nodular masses. Video-assisted thoracoscopic pericardial biopsy was performed. Histopathology confirmed actinomycosis with chronic abscess formation, and a tissue culture yielded Aggregatibacter actinomycetemcomitans. The symptoms resolved with administration of clindamycin for 6 months. This case highlights the challenge in the diagnosis of cardiac actinomycosis, the potential role of concomitant microorganisms as diagnostic clues, and the favorable clinical response achieved with appropriate antibiotic treatment.
Collapse
Affiliation(s)
- Chun-Hsun Liao
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tzong-Yow Wu
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yen-Liang Lin
- Department of Internal Medicine, National Taiwan University Hsinchu Branch, Hsinchu, Taiwan
| | - Wang-Da Liu
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Jann-Tay Wang
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
| | - Jin-Shing Chen
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Yi-Lwun Ho
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| |
Collapse
|
4
|
Enofe N, Garcia Russo M, Kadakia ER, Axelrod PI, Friedberg J, Su S, Kumar R. Mediastinal Mass, Cancer, or Infection, Atypical Paraesophageal Actinomycosis Infection, Clinical and Surgical Approach. Am Surg 2024; 90:468-470. [PMID: 38009532 DOI: 10.1177/00031348231211039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Actinomyces israelii (AI) is a Gram-positive, rod-shaped bacterium that lives commensally on and within humans as a typical colonizer within the gastrointestinal tract, including the mouth. As an opportunistic pathogen, infection often results from tissue injury or breach of the mucosal barrier (ie, during various dental or GI procedures, aspiration, or specific pathologies such as diverticulitis). Symptoms generally present slowly as a non-tender, indurated mass that evolves into multiple abscesses, fistulae, or draining sinus tracts without regard for anatomical barriers, including fascial planes or lymphatic drainage. However, it may also present as an acute suppurative infection with pain and rapid progression to abscess formation.
Collapse
Affiliation(s)
- Nosayaba Enofe
- Division of Thoracic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
- Division of Thoracic Surgery, Temple University Hospital, Philadelphia, PA, USA
| | - Manuel Garcia Russo
- Department of Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Esha R Kadakia
- Department of Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Peter I Axelrod
- Division of Infectious Diseases, Department of Medicine, Temple University Hospital, Philadelphia, PA, USA
| | - Joseph Friedberg
- Division of Thoracic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
- Division of Thoracic Surgery, Temple University Hospital, Philadelphia, PA, USA
- Department of Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Stacey Su
- Division of Thoracic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Rohit Kumar
- Division of Thoracic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
- Division of Pulmonology, Fox Chase Cancer Center, Philadelphia, PA, USA
| |
Collapse
|
5
|
Kumar LS, Keluskar V, Naik Z. Actinomycotic osteomyelitis of the maxilla in a female patient: A rare case report with the review of the literature. Dent Med Probl 2024; 61:301-306. [PMID: 35901276 DOI: 10.17219/dmp/127639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/01/2020] [Accepted: 09/18/2020] [Indexed: 02/18/2024] Open
Abstract
Actinomycotic osteomyelitis is a rare chronic suppurative, granulomatous, fibrosing saprophytic infection. It is an endogenous infection caused by the Actinomyces species, which are part of the normal oral microflora. There is a male predilection for this type of infection, with the male to female ratio of 4:1. Though the etiopathogenesis of the infection is unclear, it is mostly attributed to the disruption of the normal oral microflora and the invasion of the microorganism into deeper tissues through a break in the mucosal barrier due to damage from trauma, extraction or previous injury. The portal of entry can be through the pulpal, periodontal or mucosal route, causing the purulent and necrotic infection of soft tissue, bone, or both. The diagnosis is usually considered when there is a persistent infection without the presence of regional lymphadenopathy and is usually confirmed through the histopathological depiction of the bacterial colonies - 'ray fungus' - as obtaining the positive culture of the causative microorganisms is difficult and is reported to be effective in less than 50%. Patients with such infections are managed with surgical debridement, followed by antibiotic therapy for a longer time period. Recent advances have been emphasized for an early diagnosis and a better prognosis of the therapy. Therefore, this paper aimed to present a rare case of actinomycotic osteomyelitis of the maxilla in a 45-year-old female patient, and also to review the literature on this rare infection.
Collapse
Affiliation(s)
- Lokesh S Kumar
- Department of Oral Medicine, Radiology and Special Care Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS Deemed-to-be University), Chennai, India
| | - Vaishali Keluskar
- Department of Oral Medicine and Radiology, Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER Deemed-to-be University), Belagavi, India
| | - Zameera Naik
- Department of Oral Medicine and Radiology, Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research (KAHER Deemed-to-be University), Belagavi, India
| |
Collapse
|
6
|
Joshi AL, Pradeep I, Nigam JS, Arora AJ, Ramamourthy B. Regular resident becomes aggressive enemy: Diagnosed on cytology. Cytopathology 2024; 35:292-295. [PMID: 37916668 DOI: 10.1111/cyt.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/10/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023]
Abstract
Actinomycosis, an oral cavity commensal, causes cervicofacial infection in patients associated with an immunosuppression state and local mucosal injuries. Bone involvement by this commensal is rare. In the present case, we report a case of left peri mandibular soft tissue, soft to firm, tender swelling in a 39-year-old immunocompetent male diagnosed as Actinomycosis infection on fine needle aspiration cytology (FNAC) and cell block preparation.
Collapse
Affiliation(s)
| | - Immanuel Pradeep
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Jitendra Singh Nigam
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | | | - Balaji Ramamourthy
- Department of ENT, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| |
Collapse
|
7
|
Clary C, Desai N, Falco C. Empyema Necessitans From Actinomyces meyeri Masquerading as an SSTI. Clin Pediatr (Phila) 2024; 63:231-234. [PMID: 37698129 DOI: 10.1177/00099228231200090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Affiliation(s)
- Cody Clary
- Division of Pediatric Hospital Medicine, Feigin Center, Texas Children's Hospital, Houston, TX, USA
| | - Nilesh Desai
- Division of Neuroradiology, Texas Children's Hospital, Houston, TX, USA
| | - Carla Falco
- Division of Pediatric Hospital Medicine, Feigin Center, Texas Children's Hospital, Houston, TX, USA
| |
Collapse
|
8
|
Imeneo A, Rindi LV, Di Lorenzo A, Cavasio RA, Vitale P, Spalliera I, Dauri M, Biasucci DG, Giuliano I, D'Agostini C, Minelli S, Bossa MC, Altieri A, Andreoni M, Malagnino V, Iannetta M, Sarmati L. Brain abscess caused by Actinomyces turicensis in a non-immunocompromised adult patient: a case report and systematic review of the literature. BMC Infect Dis 2024; 24:109. [PMID: 38245682 PMCID: PMC10799506 DOI: 10.1186/s12879-024-08995-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Actinomyces turicensis is rarely responsible of clinically relevant infections in human. Infection is often misdiagnosed as malignancy, tuberculosis, or nocardiosis, therefore delaying the correct identification and treatment. Here we report a case of a 55-year-old immunocompetent adult with brain abscess caused by A. turicensis. A systematic review of A. turicensis infections was performed. METHODS A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases MEDLINE, Embase, Web of Science, CINAHL, Clinicaltrials.gov and Canadian Agency for Drugs and Technology in Health (CADTH) were searched for all relevant literature. RESULTS Search identified 47 eligible records, for a total of 67 patients. A. turicensis infection was most frequently reported in the anogenital area (n = 21), causing acute bacterial skin and skin structure infections (ABSSSI) including Fournier's gangrene (n = 12), pulmonary infections (n = 8), gynecological infections (n = 6), cervicofacial district infections (n = 5), intrabdominal or breast infections (n = 8), urinary tract infections (n = 3), vertebral column infections (n = 2) central nervous system infections (n = 2), endocarditis (n = 1). Infections were mostly presenting as abscesses (n = 36), with or without concomitant bacteremia (n = 7). Fever and local signs of inflammation were present in over 60% of the cases. Treatment usually involved surgical drainage followed by antibiotic therapy (n = 51). Antimicrobial treatments most frequently included amoxicillin (+clavulanate), ampicillin/sulbactam, metronidazole or cephalosporins. Eighty-nine percent of the patients underwent a full recovery. Two fatal cases were reported. CONCLUSIONS To the best of our knowledge, we hereby present the first case of a brain abscess caused by A. turicensis and P. mirabilis. Brain involvement by A. turicensis is rare and may result from hematogenous spread or by dissemination of a contiguous infection. The infection might be difficult to diagnose and therefore treatment may be delayed. Nevertheless, the pathogen is often readily treatable. Diagnosis of actinomycosis is challenging and requires prompt microbiological identification. Surgical excision and drainage and antibiotic treatment usually allow for full recovery.
Collapse
Affiliation(s)
- Alessandra Imeneo
- Infectious Diseases, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Lorenzo Vittorio Rindi
- Infectious Diseases, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Andrea Di Lorenzo
- Infectious Diseases, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | | - Pietro Vitale
- Infectious Disease Clinic, Policlinico Tor Vergata, Rome, Italy
| | | | - Mario Dauri
- Department of Anaesthesiology, Emergency and Intensive Care Medicine, Policlinico Tor Vergata, Rome, Italy
| | | | - Ilaria Giuliano
- Emergency and Reception Department, Anesthesia and Resuscitation Unit, Policlinico Tor Vergata, Rome, Italy
| | | | - Silvia Minelli
- Laboratory of Clinical Microbiology, Policlinico Tor Vergata, Rome, Italy
| | | | - Anna Altieri
- Laboratory of Clinical Microbiology, Policlinico Tor Vergata, Rome, Italy
| | - Massimo Andreoni
- Infectious Diseases, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Vincenzo Malagnino
- Infectious Diseases, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Marco Iannetta
- Infectious Diseases, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Loredana Sarmati
- Infectious Diseases, Department of Systems Medicine, Tor Vergata University, Rome, Italy.
| |
Collapse
|
9
|
Gupta RK, Verma KK, Ramchandani R. Scapular ulcero-nodular Actinomycosis masquerading as soft tissue tumour: A case report. Trop Doct 2024; 54:62-65. [PMID: 37769609 DOI: 10.1177/00494755231203263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Affiliation(s)
- Rakesh Kumar Gupta
- Assistant professor, Departments of Pathology, All India Institute of Medical Sciences, Raipur, Raipur, India
| | - Kartavya Kumar Verma
- Assistant professor, Departments of Pathology, All India Institute of Medical Sciences, Raipur, Raipur, India
| | | |
Collapse
|
10
|
Allan L, Said H, Shanks AM. Pulmonary actinomycosis presenting with empyema. BMJ Case Rep 2023; 16:e256320. [PMID: 37940195 PMCID: PMC10632809 DOI: 10.1136/bcr-2023-256320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023] Open
Affiliation(s)
- Liam Allan
- Respiratory Medicine, NHS Highland, Inverness, Highland, UK
| | - Hussein Said
- Respiratory Medicine, NHS Highland, Inverness, Highland, UK
| | | |
Collapse
|
11
|
Sykes C, Barik M, Kastelik J. Actinomycosis with Fusobacterium empyema. BMJ Case Rep 2023; 16:e252867. [PMID: 37714555 PMCID: PMC10510894 DOI: 10.1136/bcr-2022-252867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
Actinomyces, are gram-positive, non-spore forming anaerobic or microaerophilic species. Empyema due to actinomycosis is relatively rare and can be difficult to diagnose as the presenting symptoms may be indolent and the micro-organism may be difficult to culture. This case report describes a patient presenting with dyspnoea, weight loss and lethargy. The chest radiograph, CT and thoracic ultrasound revealed a left-sided pleural effusion. A chest drain was inserted under ultrasound guidance. The pleural fluid was macroscopically consistent with pus and microbiology showed growth of gram-positive bacilli, Actinomyces meyeri as well as the Fusobacterium species. The patient was treated with a drainage of the pleural fluid, a prolonged course of antibiotics and made a good recovery. The awareness that the Actinomyces species and the Fusobacterium species through their synergistic interaction may cause empyema, may lead to a timely diagnosis and treatment.
Collapse
Affiliation(s)
| | - Milan Barik
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Jack Kastelik
- Hull University Teaching Hospitals NHS Trust, Hull, UK
| |
Collapse
|
12
|
Kövér Z, Johansen Nordskag V, Bán Á, Gajdács M, Urbán E. The role of Actinomyces spp. and related organisms in cervicofacial infections: Pathomechanism, diagnosis and therapeutic aspects. Anaerobe 2023; 82:102767. [PMID: 37482285 DOI: 10.1016/j.anaerobe.2023.102767] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/26/2023] [Accepted: 07/20/2023] [Indexed: 07/25/2023]
Abstract
Members of the Actinomyces genus and Actinomyces-like organisms (ALOs; namely Actinotignum, Arcanobacterium, Schaalia and Varibaculum) are Gram-positive, non-spore-forming rods that are commensal members of the human oral cavity, gastrointestinal tract, female genital tract and skin microbiota. Cervicofacial actinomycosis or "lumpy jaw syndrome" - the chronic, suppurative granulomatous disease caused by Actinomyces spp. And ALOs - is characterized by an initially slow and unspecific disease-presentation, which often mimics other pathologies, followed by the formation of painful abscesses and severe tissue destruction. Actinomycosis has been described as a rare disease, however, reliable epidemiological data are lacking. In addition, there is increasing awareness regarding the role of Actinomyces spp. in the development of osteoradionecrosis and medication-related osteonecrosis of the jaw. The aim of this narrative review is to succinctly summarize the current advances regarding the microbiological, clinical, diagnostic and therapeutic aspects of cervicofacial actinomycosis, in addition to the roles of Actinomyces species and ALOs as members of the oral microbiota and in dental biofilm, in other dental infections (caries, root canal infection, periapical infection, periodontitis) and osteonecrosis of the jaw, in the context of recent taxonomic changes affecting the genus. Our paper aims to be a blueprint for dentists, other physicians, microbiologists and researchers regarding the multifaceted field of cervicofacial actinomycosis.
Collapse
Affiliation(s)
- Zsanett Kövér
- Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of Pécs, Tüzér U. 1., 7623, Pécs, Hungary.
| | - Vidar Johansen Nordskag
- Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of Pécs, Tüzér U. 1., 7623, Pécs, Hungary.
| | - Ágnes Bán
- Department of Dentistry, Oral and Maxillofacial Surgery, Medical School, University of Pécs, Tüzér U. 1., 7623, Pécs, Hungary.
| | - Márió Gajdács
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6725, Szeged, Hungary.
| | - Edit Urbán
- Department of Medical Microbiology and Immunology, Clinical Center, University of Pécs, Szigeti út 12., 7624, Pécs, Hungary.
| |
Collapse
|
13
|
Vargas-Garcia EK, Fernandez-Aristi AR, Cornejo-Venegas G, Montenegro-Idrogo JJ, Chirinos-Vega J, Chiappe-Gonzalez A. Unmasked immune reconstitution inflammatory syndrome towards B-cell non-Hodgkin lymphoma during treatment of esophageal actinomycosis in a patient with advanced HIV: a case report. AIDS Res Ther 2023; 20:48. [PMID: 37452343 PMCID: PMC10347741 DOI: 10.1186/s12981-023-00526-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/13/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Actinomycosis is an unusual chronic bacterial infection, even rarer in people living with HIV. It is not considered an AIDS-defining disease. However, the role in co-presentation or overlap with other opportunistic conditions of advanced HIV is unknown. CASE PRESENTATION A 49-year-old Peruvian male presented with a 4-month history of dysphagia, odynophagia, hyporexia and wasting. He underwent an upper digestive endoscopy, in which ulcers with a necrotic center were observed, therefore, the initial diagnostic assumption was esophageal cancer. Subsequent pathology report excluded neoplasms and confirmed the diagnosis of actinomycosis. Serology for human immunodeficiency virus was requested, yielding a positive result. Antimicrobial treatment with amoxicillin and antiretroviral therapy were indicated, with slow clinical improvement. After 4 months, epigastric discomfort presented, for which a new upper digestive endoscopy was performed, revealing a deep gastric ulcer, which was compatible with diffuse large B-cell non-Hodgkin lymphoma. CONCLUSION Esophageal actinomycosis in people living with HIV is very rare. We suggest HIV-associated immunosuppression is not enough to allow for actinomycosis to develop, and masked underlying entities should be sought. The existence of such entities in people living with HIV should raise awareness of the possibility of unmasked immune reconstitution inflammatory syndrome once treatment has started.
Collapse
Affiliation(s)
- Elsa K. Vargas-Garcia
- Universidad Peruana de Ciencias Aplicadas, Avenida Alameda San Marcos cuadra 2 S/N, Chorrillos, Lima, 15023 Peru
| | - Augusto R. Fernandez-Aristi
- Universidad Peruana de Ciencias Aplicadas, Avenida Alameda San Marcos cuadra 2 S/N, Chorrillos, Lima, 15023 Peru
| | - Gonzalo Cornejo-Venegas
- Universidad Peruana de Ciencias Aplicadas, Avenida Alameda San Marcos cuadra 2 S/N, Chorrillos, Lima, 15023 Peru
| | - Juan José Montenegro-Idrogo
- Hospital Nacional Dos de Mayo. Parque “Historia de la Medicina Peruana” S/N, Lima, 15003 Peru
- Facultad de Ciencias de la Salud, Universidad Científica del Sur. Carretera Panamericana, Sur km19, Villa El Salvador, Lima, 15067 Peru
- Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales, Universidad Nacional Mayor de San Marcos, Lima, 070102 Peru
| | - Juan Chirinos-Vega
- Clínica Angloamericana, Calle Alfredo Salazar 350, Lima, San Isidro 15073 Peru
| | - Alfredo Chiappe-Gonzalez
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Peru
- Clínica Angloamericana, Calle Alfredo Salazar 350, Lima, San Isidro 15073 Peru
| |
Collapse
|
14
|
Samaila MO, Sani K, Shofoluwe NA, Rimamskep IY. Incidental histopathological diagnosis of tonsilar actinomycosis: A report of four cases. Niger Postgrad Med J 2023; 30:262-264. [PMID: 37675704 DOI: 10.4103/npmj.npmj_325_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Actinomycosis of the tonsils is uncommon even though the causative organisms are normal commensal of the oropharyngeal tract that may colonise the tonsillar crypts with resultant infection in apparently healthy individuals. Diagnosis is often incidental in tonsillectomy specimens sent to the pathology laboratory for varied diseases. This is a 10-year study of tonsillectomy specimens diagnosed with actinomycosis. Specimens were formalin-fixed and paraffin processed and stained with haematoxylin and eosin, gromott methenamine silver and periodic acid-Schiff. Four cases of tonsillar actinomycosis were diagnosed from a total of 772 tonsillectomy specimens. Histologically, characteristic oeosinophilic granules with peripheral radial protuberances surrounded by microabscesses were seen. Tonsillar actinomycosis is often an incidental diagnosis; however, a high index of suspicion should be entertained in patients with recurrent tonsillitis and/or tonsillar hypertrophy of unknown cause.
Collapse
Affiliation(s)
- Modupeola Omotara Samaila
- Department of Pathology, Faculty of Basic Clinical Sciences, College of Medical Sciences, Ahmadu Bello University; Department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Kamarudeen Sani
- Department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Nurudeen Adebola Shofoluwe
- Division of Otorhinolaryngology, Department of Surgery, Faculty of Clinical Sciences, Ahmadu Bello University; Department of Otorhinolaryngology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | | |
Collapse
|
15
|
Jenkins C, Ganapathy A, Fancher C, Matsushima K. Persistent Multispecies Actinomyces Mastitis Treated With Repeated Aspiration and Long-Term Oral Antibiotics. Am Surg 2023; 89:2076-2078. [PMID: 34105994 DOI: 10.1177/00031348211025748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Actinomycosis is an infection characterized by abscess formation, draining sinuses, and tissue fibrosis. The causative bacterium is a Gram-positive facultative anaerobe from the genus Actinomyces. Infections classically affect the cervicofacial, thoracic, or pelvic region and often require prolonged antibiotic therapy. Actinomycosis of the breast is a rare condition that may present as a recurrent breast abscess. We present a 33-year-old female with a recurrent breast abscess which grew A. radingae and A. israeli on aspirated fluid cultures. Treatment with surgical aspiration and a 6-week course of oral amoxicillin/clavulanic acid 875 mg twice daily resulted in clinical improvement. Our case demonstrates how recurrent breast abscesses caused by Actinomyces can be difficult to manage. Long-term antibiotic therapy with surgical aspiration and regular follow-up offer the best chance of clinical resolution.
Collapse
Affiliation(s)
- Colin Jenkins
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Anand Ganapathy
- Department of Surgery, University of Southern California, Los Angeles, CA, USA
| | - Crystal Fancher
- Department of Surgery, University of Southern California, Los Angeles, CA, USA
| | - Kazuhide Matsushima
- Department of Surgery, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
16
|
Anannamcharoen S, Nimmanon T, Boonya-Ussadorn C. Abdominal actinomycosis mimicking colon cancer. Asian J Surg 2023; 46:1536-1538. [PMID: 36253265 DOI: 10.1016/j.asjsur.2022.09.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/16/2022] [Indexed: 11/20/2022] Open
|
17
|
Mansouri H, Zemni I, souissi M, Henchiri H, Boukhris S, Ayadi MA, Achouri L. Pseudo tumor pelvic actinomycosis revealed by colonic obstruction with hydronephrosis: Can extensive surgery be avoided? A case report. Womens Health (Lond) 2023; 19:17455057231181009. [PMID: 37480326 PMCID: PMC10363873 DOI: 10.1177/17455057231181009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/12/2023] [Accepted: 05/23/2023] [Indexed: 07/24/2023]
Abstract
Pelvic actinomycosis with an intrauterine device accounts for approximately 3% of all actinomycoses. It is a chronic infectious disease characterized by infiltrative, suppurative, or granulomatous inflammation, sinus fistula formation, and extensive fibrosis, and caused by filamentous, gram-positive, anaerobic bacteria called Actinomyces israelii. The slow and silent progression favors pseudo tumor pelvic extension and exposes the patient to acute life-threatening complications, namely colonic occlusion with hydronephrosis. Preoperative diagnosis is often difficult due to the absence of specific symptomatology and pathognomonic radiological signs simulating pelvic cancer. We discuss the case of a 67-year-old woman who complained of pelvic pain, constipation, and weight loss for 4 months, and who presented to the emergency department with a picture of colonic obstruction and a biological inflammatory syndrome. The computed tomography scan revealed a suspicious heterogeneous pelvic mass infiltrating the uterus with an intrauterine device, the sigmoid with extensive upstream colonic distension, and right hydronephrosis. The patient underwent emergency surgery with segmental colonic resection and temporary colostomy, followed by antibiotic therapy. The favorable clinical and radiological evolution under prolonged antibiotic therapy with the almost total disappearance of the pelvic pseudo tumor infiltration confirms the diagnosis of pelvic actinomycosis and thus makes it possible to avoid an extensive and mutilating surgery with important morbidity.
Collapse
Affiliation(s)
- Houyem Mansouri
- Department of Surgical Oncology, Regional Hospital of Jendouba, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ines Zemni
- Department of Surgical Oncology, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Laboratory of Microorganisms and Active Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Malek souissi
- Department of Radiology, Taoufik Hospitals Group, Tunis, Tunisia
| | - Houda Henchiri
- Department of Surgical Oncology, Regional Hospital of Jendouba, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sabrine Boukhris
- Department of Surgical Oncology, Regional Hospital of Jendouba, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Mohamed Ali Ayadi
- Department of Surgical Oncology, Salah Azaiez Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Laboratory of Microorganisms and Active Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Leila Achouri
- Department of Surgical Oncology, Regional Hospital of Jendouba, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| |
Collapse
|
18
|
Mitrović M, Janković R, Đuknić M, Simić L, Poljašević N, Jevtić J. Pediatric appendicular actinomycosis: a case report and literature review. Turk J Pediatr 2023; 65:687-692. [PMID: 37661685 DOI: 10.24953/turkjped.2023.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND Actinomycosis (ACM) is a rare infectious granulomatous disease caused by Actinomyces, a Grampositive, filamentous, saprophytic bacteria. There are several types of pediatric ACM, such as orocervicofacial (55%) and other less common forms: abdominopelvic and thoracic. We report a case of a 16-year-old who presented with abdominal ACM in the setting of acute appendicitis. After the case report, we provide a short literature review of pediatric appendicular ACM cases published. CASE A 16-year-old boy presented with nausea, vomiting, pain in the upper part of the abdomen and fever (37.5°C) lasting for 24 hours. On physical examination, the patient`s epigastrium and lower right abdominal quadrant were tender. White cell count and C-reactive protein (CRP) were elevated at 16,300/μL and 48.6mg/L respectively. Ultrasonography (US) showed appendicolith and edema of the appendiceal wall, focally with stratification as well as periappendiceal inflammation. The patient underwent a classic appendectomy, and the postoperative course was without complications. Histopathological analysis showed diffuse transmural neutrophilic infiltration of the appendix, focally with areas of necrosis and abscesses. There were numerous brightly eosinophilic colonies made of filamentous bacteria, located predominantly in submucosa. Special stains Grocott-Gomori`s Methenamine Silver and Gram were positive and a diagnosis of ACM was made. CONCLUSIONS Although appendicitis is very common in the general population, appendicitis associated with ACM is very rare, accounting for 0.02% - 0.06%, especially in the pediatric population. Diagnosis can be very challenging because they usually present with non-specific symptoms, and can form masses that mimic malignancies. Although rare, clinicians and pathologists should be aware of this entity. Satisfactory results and complete cure are achieved with adequate antibiotic therapy and surgery. In most cases, if there are no associated diseases, early and accurate diagnosis ensure an excellent prognosis.
Collapse
Affiliation(s)
- Marija Mitrović
- Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Radmila Janković
- Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Miloš Đuknić
- Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ljubica Simić
- Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nevena Poljašević
- Department of Pathology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Jovan Jevtić
- Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
19
|
Moaddabi A, Cernera M, Armogida NG, Soltani P, Spagnuolo G. Actinomycotic Sinomaxillary Infection in a COVID-19 Patient: A Case Report and Review of the Literature. J Investig Med High Impact Case Rep 2023; 11:23247096231217823. [PMID: 38102073 PMCID: PMC10725094 DOI: 10.1177/23247096231217823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/05/2023] [Accepted: 11/12/2023] [Indexed: 12/17/2023] Open
Abstract
Individuals with COVID-19 are prone to a variety of infections due to immune dysregulation. The present report presents a case of actinomycotic infection in the maxillary bone and sinus region in a patient with a history of COVID-19. This case report highlights the importance of considering bacterial infections including actinomycosis when encountering destructive lesions resembling more prevalent fungal infections due to different therapeutic medication protocols. In addition, a literature review of the existing reports of similar post-COVID-19 actinomycotic infection is presented.
Collapse
Affiliation(s)
- Amirhossein Moaddabi
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mariangela Cernera
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, Italy
| | - Niccolò Giuseppe Armogida
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, Italy
| | - Parisa Soltani
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, Italy
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, Italy
| |
Collapse
|
20
|
Abdulkarim A, Pouxe M, De Vallière S, Beigelman C, Favrat B, Kokkinakis I. [Clinical presentation and short-term treatment of pulmonary actinomycosis]. Rev Med Suisse 2022; 18:2177-2180. [PMID: 36382979 DOI: 10.53738/revmed.2022.18.804.2177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Actinomycosis is an uncommon disease caused by Actinomyces, a commensal of the oropharyngeal, digestive, and genital tract. Commonly, it manifests as cervicofacial infection and is often related to poor oral health, smoking, chronic alcoholism or immune deficiency. Pulmonary actinomycosis is a rare disease, characterized by unspecific clinical, biological, and radiological manifestations that may be confused with other diseases. It should always be considered in patients suspected of having tuberculosis, lung abscess or pulmonary neoplasia. We describe a case of pulmonary actinomycosis treated successfully with short-term antibiotic therapy of three months, with a short review of the literature.
Collapse
Affiliation(s)
- Aziz Abdulkarim
- Unisanté, Centre universitaire de médecine générale et de santé publique, 1011 Lausanne
| | - Marie Pouxe
- Unisanté, Centre universitaire de médecine générale et de santé publique, 1011 Lausanne
| | - Serge De Vallière
- Unisanté, Centre universitaire de médecine générale et de santé publique, 1011 Lausanne
- Service de maladies infectieuses, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Catherine Beigelman
- Département de radiologie diagnostique et interventionnelle, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Bernard Favrat
- Unisanté, Centre universitaire de médecine générale et de santé publique, 1011 Lausanne
| | - Ioannis Kokkinakis
- Unisanté, Centre universitaire de médecine générale et de santé publique, 1011 Lausanne
| |
Collapse
|
21
|
Hoca NT, Berktaş MB, Söyler Y, Celep C, Tanrıkulu FB. Clinical features and treatment outcomes of pulmonary actinomycosis. Eur Rev Med Pharmacol Sci 2022; 26:8064-8072. [PMID: 36394726 DOI: 10.26355/eurrev_202211_30160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Pulmonary actinomycosis is a rare and chronic infectious disease that mimics malignancy and is frequently misdiagnosed. There are few reports that address the clinical characteristics of pulmonary actinomycosis. The objective of this research is to evaluate the clinical features, radiological findings, diagnostic approaches and treatment outcomes of pulmonary actinomycosis. PATIENTS AND METHODS Thirty-seven patients with pulmonary actinomycosis histopathologically diagnosed from 2009 to 2021 were analyzed retrospectively. RESULTS The mean age at presentation was 53.7 (±13.3) years. Frequent symptoms were cough and hemoptysis. The median diagnosis time from the first symptoms was 60 days (interquartile range 18-195). Pulmonary comorbidity was found in 59.5% of cases. The most common thorax computed tomography finding was mass or nodule. The low-attenuation center within the mass or consolidation was observed in 40% of the lesions. The median maximal standardized uptake value of lesions on positron emission tomography (PET) was 6.5 (interquartile range 2.7-10.3). In the majority of cases (97.3%), the diagnosis of pulmonary actinomycosis was not suspected at admission, and 56.8% of patients were misdiagnosed with lung cancer. The mean duration of antibiotic therapy was 9.4 days (range 3-22) with intravenous antibiotics and 64.7 days (range 5-270) with oral antibiotics. Four patients died due to concomitant comorbidities. Eight cases were lost to follow-up. All other cases were fully cured. CONCLUSIONS Pulmonary actinomycosis mimics other diseases, often lung cancer. Clinicians should consider the diagnosis of actinomycosis when they detect a mass or consolidation, especially with a low-attenuation center. PET/CT appears not to be useful for differential diagnosis. A shorter course of antibiotic therapy than traditionally recommended appears to be sufficient.
Collapse
Affiliation(s)
- N T Hoca
- Department of Chest Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | | | | | | | | |
Collapse
|
22
|
Arnal Etienne A, van Maanen A, Van Eeckhout P, Magremanne M. Actinomycosis and osteonecrosis of the jaw: Every why hides a why. J Stomatol Oral Maxillofac Surg 2022; 123:e749-e756. [PMID: 35640875 DOI: 10.1016/j.jormas.2022.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 04/10/2022] [Accepted: 05/27/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Andrea Arnal Etienne
- Department of oral and maxillo-facial surgery, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, 10, avenue Hippocrate, 1200 Brussels, Belgium.
| | - Aline van Maanen
- Statistical support unit, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, 10, avenue Hippocrate, 1200 Brussels, Belgium; Institut Roi Albert II, Cancérologie et Hématologie, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, 10, avenue Hippocrate, 1200 Brussels, Belgium
| | - Pascal Van Eeckhout
- Department of pathology, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, 10, avenue Hippocrate, 1200 Brussels, Belgium; Institut Roi Albert II, Cancérologie et Hématologie, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, 10, avenue Hippocrate, 1200 Brussels, Belgium
| | - Michèle Magremanne
- Department of oral and maxillo-facial surgery, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, 10, avenue Hippocrate, 1200 Brussels, Belgium; Institut Roi Albert II, Cancérologie et Hématologie, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, 10, avenue Hippocrate, 1200 Brussels, Belgium
| |
Collapse
|
23
|
Afsin E, Bacaksu E. Endobronchial Actinomycosis: A Case Report. Niger J Clin Pract 2022; 25:1758-1761. [PMID: 36308251 DOI: 10.4103/njcp.njcp_1357_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
An extremely rare disease with a slow course, actinomycosis has a high mortality risk when not properly treated. Pulmonary actinomycosis is clinically and radiologically analogous with tuberculosis, foreign body aspiration, lung abscess, or lung cancer. Therefore, it often causes misdiagnosis or delay in diagnosis. A 65-year-old male patient, being followed up with the diagnosis of chronic obstructive pulmonary disease (COPD) and lung adenocarcinoma, was admitted to our outpatient clinic with complaints of chronic cough. On chest CT, a cavitary lesion in the upper lobe of the right lung was observed. Sputum Acid Fast Bacilli (AFB) was negative for 3 consecutive times, fungal direct examination was negative, and there was no growth in mycobacterium culture and fungal culture. Flexible bronchoscopy revealed a raised, hard, white-colored lesion on the mucosa obliterating the apical and anterior segment bronchial entrance of the right lung upper lobe. A diagnosis of actinomycosis was made with sulfur granules seen in the pathology as a result of biopsy and lavage. Detection of sulfur granules in biopsy is essential for the diagnosis of actinomycosis, and a nearly complete response is usually obtained with long-term antibiotic treatment. Alternative methods such as surgical debridement should be considered in cases that do not respond to antibiotic treatment.
Collapse
Affiliation(s)
- E Afsin
- Department of Chest Diseases, Abant Izzet Baysal University Hospital, Golkoy, Bolu, Turkey
| | - E Bacaksu
- Department of Chest Diseases, Abant Izzet Baysal University Hospital, Golkoy, Bolu, Turkey
| |
Collapse
|
24
|
Nuez-Zaragoza E, Sanfeliu I. Acute necrotizing chorioamnionitis caused by Actinomyces neuii. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:458-459. [PMID: 36195410 DOI: 10.1016/j.eimce.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/23/2021] [Indexed: 06/16/2023]
Affiliation(s)
- Elisa Nuez-Zaragoza
- Department of Microbiology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.
| | - Isabel Sanfeliu
- Department of Microbiology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| |
Collapse
|
25
|
Alsuliman T, Ikhlef S, Stocker N, Kaoui F, Ricard L, Ledraa T, Ellouz C, de Wyngaert ZV, Malard F, Cervera P, Corre E, Mohty M, Marjanovic Z. Actinomycosis in a mandibular necro-osteolytic lesion in a patient with multiple myeloma treated with bisphosphonates. Curr Res Transl Med 2022; 70:103359. [PMID: 35714463 DOI: 10.1016/j.retram.2022.103359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/13/2022] [Accepted: 06/06/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Tamim Alsuliman
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| | - Souhila Ikhlef
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France.
| | - Nicolas Stocker
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| | - Fazia Kaoui
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| | - Laure Ricard
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| | - Tounes Ledraa
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| | - Cyrine Ellouz
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| | - Zoé Van de Wyngaert
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| | - Florent Malard
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| | - Pascale Cervera
- Laboratoire d'Anatomie Pathologique, INSERM, Hopital Saint-Antoine, Sorbonne Université, UMRS 938, France
| | - Elise Corre
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| | - Mohamad Mohty
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| | - Zora Marjanovic
- Sorbonne University, Paris, France; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France; INSERM, UMRs 938, Paris, France
| |
Collapse
|
26
|
Cakiroglu B, Kaya C, Aksoy SH, Gozukucuk R, Ates L. Urachal Actinomycosis Presenting with Recurrent Urinary Tract Infections in a Middle-aged Woman: A Rare Case Report. J Coll Physicians Surg Pak 2022; 32:668-670. [PMID: 35546708 DOI: 10.29271/jcpsp.2022.05.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/22/2021] [Indexed: 06/15/2023]
Abstract
The urachal cyst, a remnant of allantois sac during embryogenesis, is a rare condition in adulthood. Urachus is an embryologic remnant degenerating after birth. Abberrant obliteration of the urachus causes urachal abnormalities. The urachal cysts are almost always symptomatic when infected. The symptoms include fever, abdominal pain, tenderness, lower abdominal mass, nausea, vomiting, and dysuria. Ultrasonography, computerised tomography, and magnetic resonance imaging techniques may be insufficient for diagnosis. In most cases, staphylococcus species are isolated from cultures of urachal cysts. Other microorganisms such as Escherichia coli, Enterococcus faecium, Klebsiella pneumonia, and rarely actinomyces may be isolated. Actinomyces, an anaerobic gram-positive filamentous bacterium, is a rare cause of granulomatous disease. In this case report, a 56-year woman with urachal cyst infection with actinomyces is discussed according to current knowledge. Key Words: Urachal cyst, Urachus, Chronic cystitis, Actinomyces.
Collapse
Affiliation(s)
- Basri Cakiroglu
- Istanbul Galata University, Department of Urology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Cevdet Kaya
- Department of Urology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Suleyman Hilmi Aksoy
- Istanbul Galata University, Department of Radiology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Ramazan Gozukucuk
- Istanbul Galata University, Department of Infectious Diseases, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Lora Ates
- Department of Pathology, Hisar Intercontinental Hospital, Istanbul, Turkey
| |
Collapse
|
27
|
Sanford JA, Rush WL, Klassen-Fischer MK, Allbritton JI. Cutaneous Actinomycosis of the Perineum in an Immunocompetent Man. Am J Dermatopathol 2022; 44:272-275. [PMID: 34726184 DOI: 10.1097/dad.0000000000002095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We present a case of primary cutaneous actinomycosis of unclear pathogenesis. A 30-year-old-man with no significant medical or surgical history presented to the emergency department with a 2-week history of a tender perineal mass. The patient denied trauma or perforating injury to the area. Examination of the area revealed an indurated, nonfluctuant, erythematous papulonodule located 2 cm from the anus. The lesion was unresponsive to oral and topical antibiotics and was therefore excised. The excision specimen revealed a dense mixed infiltrate partially filling the reticular dermis and extending into the subcutaneous fat. The infiltrate surrounded grains of basophilic material with an outer rim of eosinophilic radiating Splendore-Hoeppli material. Within the grains, filamentous bacteria were highlighted with Periodic acid-Schiff and Grocott's methenamine silver. The organisms were gram-positive and acid-fast negative. Given the clinical and histopathologic findings, actinomycosis was diagnosed. Two weeks later, the patient reported resolution of symptoms. The patient was lost to follow-up. This case highlights an unusual presentation of actinomycosis and the crucial role histopathology plays in diagnosis.
Collapse
Affiliation(s)
- Jeffrey A Sanford
- Department of Pathology, Walter Reed National Military Medical Center, Bethesda, MD
| | - Walter L Rush
- Division of Dermatopathology, Joint Pathology Center; and
| | | | | |
Collapse
|
28
|
Torun BC, Gök AFK, İlhan M, Yegen G, Başaran S, Ertekin C, Günay MK, Yanar H. A rare cause of acute abdominal pain: Actinomyces infection of colon mimicking a malignant neoplasm due to intrauterine device. ULUS TRAVMA ACIL CER 2022; 28:537-540. [PMID: 35485507 PMCID: PMC10520999 DOI: 10.14744/tjtes.2020.45672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/12/2020] [Indexed: 11/20/2022]
Abstract
Actinomycosis is a rare, chronic granulomatous disease that is challenging to diagnose because the clinical symptoms and signs are nonspecific. Usage of intrauterine device (IUD) or being immunocompromised is facilitating factors. Clinical and radiological findings can mimic malignant neoplasm, inflammatory bowel disorder, or acute diverticulitis. We report a case of actinomyces infection of the colon secondary to IUD, which is a rare cause of acute abdominal pain and can mimic a malignant neoplasm. We also provide a review of the literature. Unnecessary surgery can be avoided with the correct diagnosis of granulomatous infectious diseases that can be treated with antibiotics.
Collapse
Affiliation(s)
- Bahar Canbay Torun
- Department of General Surgery, Sultangazi Haseki Training and Research Hospital, İstanbul-Turkey
| | - Ali Fuat Kaan Gök
- Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey
| | - Mehmet İlhan
- Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey
| | - Gülçin Yegen
- Department of Pathology, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey
| | - Seniha Başaran
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey
| | - Cemalettin Ertekin
- Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey
| | - Mustafa Kayıhan Günay
- Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey
| | - Hakan Yanar
- Department of General Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey
| |
Collapse
|
29
|
Kaplan K, Sarıcı KB, Usta S, Özdemir F, Işık B, Yılmaz S. Primary Hepatic Actinomycosis Mimicking Neuroendocrine Tumor. J Gastrointest Cancer 2022; 54:294-296. [PMID: 35184235 DOI: 10.1007/s12029-022-00806-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The Actinomyces species is a fastidious, gram-positive, non-spore-forming bacteria that thrive in microareophilic and anaerobic conditions. Infection in the liver, an organ rarely affected by this pathogen, is presumed to be caused by hematogenous spread through the portal vein from a mucosal injury or other abdominal injury or a focus of infection. CASE DESCRIPTION A 60-year-old male patient has a mass lesion of 15 × 10 cm in the left lobe on computed tomography. A tru-cut biopsy was performed with USG, and fragmented tissue pieces were obtained. In histopathological examination, these samples were reported as tumors with neuroendocrine differentiation. The biopsy sample contains a large amount of tumor neighborhood, and tumoral area is quite small. And, therefore, a clear diagnosis could not be found. A mass lesion with mildly increased Ga 68 DOTATATE uptake was observed in the left lobe of the liver (SUVmax value 3.8) and was interpreted in favor of the primary neuroendocrine tumor of the liver. DISCUSSION Actinomyces cases are very rare and their diagnosis is usually delayed due to its slow and insidious course, and lack of specific clinical and radiological findings. It is difficult to make a correct diagnosis even in microbiological examinations and biopsy materials obtained in the presence of imaging methods. It can mimic tumors of abdominopelvic structures. CONCLUSION Actinomyces should be kept in mind in cases with liver masses accompanied by previous abdominal surgery, abdominal trauma, high fever, and leukocytosis.
Collapse
Affiliation(s)
- Kuntay Kaplan
- Department of General Surgery, Inonu University, Malatya, Turkey.
| | | | - Sertaç Usta
- Department of General Surgery, Inonu University, Malatya, Turkey
| | - Fatih Özdemir
- Department of General Surgery, Inonu University, Malatya, Turkey
| | - Burak Işık
- Department of General Surgery, Inonu University, Malatya, Turkey
| | - Sezai Yılmaz
- Department of General Surgery, Inonu University, Malatya, Turkey
| |
Collapse
|
30
|
Cliffe A, Hassan W, Ward D, Elgara M. Actinomyces meyeri causing disseminated actinomycosis in the presence of concurrent bronchogenic carcinoma. BMJ Case Rep 2022; 15:e247577. [PMID: 35135804 PMCID: PMC8830196 DOI: 10.1136/bcr-2021-247577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 11/04/2022] Open
Abstract
We describe the presentation of a 72-year-old woman with concurrent diagnoses of lung adenocarcinoma in conjunction with disseminated Actinomyces meyeri infection; a rare pathogen which can mimic lung cancer both symptomatically and radiologically. The patient was found to have a pelvic mass initially presumed to be cervical metastases-later confirmed to be of xanthogranulomatous inflammatory origin following transvaginal ultrasound-guided biopsy. The pathogenic cause, identified following pleural aspirate, being a fully sensitive A. meyeri infection; treated with prolonged course amoxicillin.
Collapse
Affiliation(s)
- Adam Cliffe
- Respiratory Medicine, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Wafa Hassan
- Respiratory Medicine, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Daniel Ward
- Radiology Department, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Mohamed Elgara
- Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
31
|
Maraki S, Mavromanolaki VE, Stafylaki D, Anagnostopoulou E, Moraitis P, Kasimati A, Treptow B. A 60-Year Literature Review on Hepatic Actinomycosis. Med Princ Pract 2022; 31:103-110. [PMID: 35038716 PMCID: PMC9209987 DOI: 10.1159/000521990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/13/2022] [Indexed: 11/19/2022] Open
Abstract
Hepatic actinomycosis (HA) is a rare infection with an indolent course, atypical clinical manifestations, nonspecific laboratory and imaging findings, and challenging diagnosis. We describe a case of a 35-year-old female who developed HA 2 weeks after gastrectomy. In addition, we analyzed clinical characteristics and outcome of 157 additional cases of HA identified in a 60-year literature review. Patients with HA were predominantly male (57%) and more than one-half were between 40 and 70 years of age. The infection was cryptogenic in 80.8% of cases. Risk factors for HA were identified in 63.1% of the patients. Clinical presentation included fever (57.7%), abdominal pain (52.1%), weight loss (45.1%), anorexia (27.5%), fatigue and chills (12.7% each), and malaise (12%) over a 2.35 ± 3.5 months period. Leukocytosis, elevated alkaline phosphatase, erythrocyte sedimentation rate, and C-reactive protein were the most frequent laboratory findings. Radiologic imaging revealed that the right lobe was more frequently affected (62.5%) with a single lesion found in two-thirds of cases. Diagnosis was achieved by histopathologic examination in 70.6% of cases. Cultures yielded Actinomyces in 45 instances, with A. israelii being the most frequent species. Less than one-half of the patients were treated only with antibiotics, while the others received combined medical and surgical treatment. The median duration of antibiotic therapy was 135 days. The presence of multiple lesions or solid tumor-like lesions (without liquefaction) was significantly associated with medical therapy alone. The outcome was favorable in most cases (94%). Although rarely encountered, HA should be considered in patients with a chronic or subacute inflammatory process of the liver to promptly diagnose and treat.
Collapse
Affiliation(s)
- Sofia Maraki
- Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, Heraklion, Greece
- *Sofia Maraki,
| | | | - Dimitra Stafylaki
- Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, Heraklion, Greece
| | - Eliza Anagnostopoulou
- Department of Surgical Oncology, University Hospital of Heraklion, Heraklion, Greece
| | - Panagiotis Moraitis
- Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, Heraklion, Greece
| | - Anna Kasimati
- Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, Heraklion, Greece
| | - Boris Treptow
- Department of Surgical Oncology, University Hospital of Heraklion, Heraklion, Greece
| |
Collapse
|
32
|
Sahin R. Pseudoactinomycotic Radiate Granules (PAMRAGs) in the Extensor Tendon of Hand. J Coll Physicians Surg Pak 2021; 31:1503-1505. [PMID: 34794297 DOI: 10.29271/jcpsp.2021.12.1503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/03/2020] [Indexed: 06/13/2023]
Abstract
Pseudoactinomycotic radiate granules (PAMRAGs) are most frequently observed in female genitalia. Morphologically, these closely resemble the actual actinomycotic granules. Actinomyces are infectious organisms that require treatment; whereas, PAMRAGs do not require a specific treatment since they are not infectious. Here, we describe a previously unreported case of these granules in the hand. A 56-year woman was admitted with soft mass on the dorsal aspect of her right hand. Peroperatively, lesion was detected in the extensor digitorum communis. Histopathological examination revealed an appearance that resembled actinomyces. Periodic acid-Schiff (PAS) staining was not positive for actinomyces. Hematoxylin-eosin (HE) staining showed radially arranged refractile granules with thick, irregular club-like eosinophilic character without a central core. Thus, actinomycosis was ruled out and a diagnosis of PAMRAGs was made. Differentiating PAMRAGs from actual actinomycotic infections is crucial for the treatment. Pathologists should be familiar with the presence and appearance of PAMRAGs to avoid misdiagnosis of actinomycosis and prevent unnecessary antibiotic use. Key Words: Pseudoactinomycotic radiate granules (PAMRAGs), Extensor tendon, Actinomyces, Hand.
Collapse
Affiliation(s)
- Rifat Sahin
- Department of Orthopaedia and Traumatology, Faculty of Medicine, Recep Tayyip Erdogan University, Turkey
| |
Collapse
|
33
|
Shrestha B, Regmi M, Adhikari P. Actinomycosis of Gallbladder in Cholecystectomy Specimen: A Case Report. JNMA J Nepal Med Assoc 2021; 59:1177-1179. [PMID: 35199761 PMCID: PMC9124337 DOI: 10.31729/jnma.6709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/17/2021] [Indexed: 11/24/2022] Open
Abstract
Actinomyces are a part of the normal flora of the cervicofacial region, gastrointestinal tract, and urogenital tract, but can cause infections when the normal mucosal barrier is lost. Herein, we report a rare case of actinomycosis of the gallbladder in a 60-years-old-female. The patient presented with right hypochondrium pain since three months; ultrasonography showed cholelithiasis with thick oedematous wall. An open cholecystectomy was carried out. Histological examination revealed an inflamed gallbladder with colonies of radiating filamentous structures having numerous sulphur granules which on gram staining showed filamentous gram-positive rods. The diagnosis of Actinomycosis of gallbladder was made. After cholecystectomy, prolonged antimicrobial therapy is recommended for patient with actinomycosis to prevent recurrence and even mortality.
Collapse
Affiliation(s)
- Brijesh Shrestha
- Department of Pathology, National Medical College and Teaching Hospital, Birgunj, Nepal
- Correspondence: Dr. Brijesh Shrestha, Department of Pathology, National Medical College and Teaching Hospital, Birgunj, Nepal. , Phone: +977-9845448809
| | - Manisha Regmi
- Department of Pathology, National Medical College and Teaching Hospital, Birgunj, Nepal
| | - Prabesh Adhikari
- Department of Pathology, National Medical College and Teaching Hospital, Birgunj, Nepal
| |
Collapse
|
34
|
Affiliation(s)
- R Floyd
- Department of Colorectal Surgery, St. James’s Hospital, Dublin 8, Ireland
- Department of Gynaecology, Gynaecological Cancer Care Centre, St. James’s Hospital, Dublin 8, Ireland
- Address correspondence to Dr R. Floyd, Department of Gynaecology, Gynaecological Cancer Care Centre, St. James’s Hospital, Dublin 8, Ireland.
| | - S Hunter
- Department of Gynaecology, Gynaecological Cancer Care Centre, St. James’s Hospital, Dublin 8, Ireland
| | - F Abu Saadeh
- Department of Gynaecology, Gynaecological Cancer Care Centre, St. James’s Hospital, Dublin 8, Ireland
| | - C McDonnell
- Department of Radiology, St. James’s Hospital, Dublin 8, Ireland
| | - P McCormick
- Department of Colorectal Surgery, St. James’s Hospital, Dublin 8, Ireland
| |
Collapse
|
35
|
Pitekova B, Kralik R, Kunzo S, Bojnansky J, Podracka L. Actinomycotic Abscess of Thyroid Gland in a 3-Year-Old Child. J Investig Med High Impact Case Rep 2021; 9:23247096211051923. [PMID: 34727751 PMCID: PMC8573521 DOI: 10.1177/23247096211051923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Actinomycosis is an atypical cause of infection in the head and neck area, especially in children. A rare incidence of actinomycosis, its nonspecific clinical signs that mimic other pathological conditions, as well as a complicated identification of microorganism lead to diagnostic delays in clinical practice. Besides an accurate diagnosis, it is of an utmost importance to pinpoint relevant predisposing factors, which might result in the infection. We present a clinical case of actinomycotic infection of the thyroid gland in the pediatric patient at our department.
Collapse
Affiliation(s)
- Barbora Pitekova
- Comenius University in Bratislava, Slovakia
- National Institute of Children’s Diseases, Bratislava, Slovakia
| | - Robert Kralik
- Comenius University in Bratislava, Slovakia
- St. Elisabeth’s Cancer Institute, Bratislava, Slovakia
| | - Samuel Kunzo
- Comenius University in Bratislava, Slovakia
- National Institute of Children’s Diseases, Bratislava, Slovakia
| | | | - Ludmila Podracka
- Comenius University in Bratislava, Slovakia
- National Institute of Children’s Diseases, Bratislava, Slovakia
- Ludmila Podracka, MD, PhD, National Institute of Children’s Diseases, Limbova 1, Bratislava 831 01, Slovakia.
| |
Collapse
|
36
|
Pinheiro TN, Freitas ES, Leite MGM, Filho RPZ, Da Silva CC, Cintra LTA. Giant sialolith associated with Actinomyces infection, suggesting a new etiopathogenic correlation: a case report. Gen Dent 2021; 69:29-33. [PMID: 34678739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sialolithiasis is a disorder of the salivary glands characterized by the presence of mineralized structures. The aim of this article is to contribute to the understanding of the etiopathogenesis of sialolithiasis based on data reported in the literature and the interpretation of scanning electron microscopic (SEM), histopathologic, fluorescence, and energy-dispersive X-ray spectroscopic (EDX) studies. The results of these analyses in a single case are presented. Fluorescence microscopy captured saliva flowing inside a giant sialolith, EDX analysis enabled the quantification of samples of minerals and characterized the chemical composition in the internal areas of the sialolith, and SEM images captured the external communications of the sialolith (ostia). Many theories have been proposed to explain sialolithiasis development, but few consider the role of saliva in its dynamic form. The authors propose that the triple synergism of microbiota, biofilm, and salivary dynamics plays a fundamental role in the development and intrinsic architecture of sialoliths, creating a cyclic sialolithic mineralization. This hypothesis is supported by the results of the laboratory studies in the present case.
Collapse
|
37
|
Hsiao YC, Lee YH, Ho CM, Tseng CH, Wang JH. Clinical Characteristics of Actinomyces viscosus Bacteremia. ACTA ACUST UNITED AC 2021; 57:medicina57101064. [PMID: 34684101 PMCID: PMC8537041 DOI: 10.3390/medicina57101064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Actinomyces species are part of the normal flora of humans and rarely cause disease. It is an uncommon cause of disease in humans. The clinical features of actinomycosis have been described, and various anatomical sites (such as face, bones and joints, respiratory tract, genitourinary tract, digestive tract, central nervous system, skin, and soft tissue structures) can be affected. It is not easy to identify actinomycosis because it sometimes mimics cancer due to under-recognition. As new diagnostic methods have been applied, Actinomyces can now more easily be identified at the species level. Recent studies have also highlighted differences among Actinomyces species. We report a case of Actinomyces viscosus bacteremia with cutaneous actinomycosis. Materials and Methods: A 66 years old male developed fever for a day with progressive right lower-leg erythematous swelling. Blood culture isolates yielded Actinomyces species, which was identified as Actinomyces viscosus by sequencing of the 16S rRNA gene. In addition, we searched for the term Actinomyces or actinomycosis cross-referenced with bacteremia or "blood culture" or "blood stream" from January 2010 to July 2020. The infectious diseases caused by species of A. viscosus from January 1977 to July 2020 were also reviewed. Results: The patient recovered well after intravenous ampicillin treatment. Poor oral hygiene was confirmed by dental examination. There were no disease relapses during the following period. Most cases of actinomycosis can be treated with penicillin. However, clinical alertness, risk factor evaluation, and identification of Actinomyces species can prevent inappropriate antibiotic or intervention. We also compiled a total of 18 cases of Actinomyces bacteremia after conducting an online database search. Conclusions: In summary, we describe a case of fever and progressive cellulitis. Actinomyces species was isolated from blood culture, which was further identified as Actinomyces viscosus by 16S rRNA sequencing. The cellulitis improved after pathogen-directed antibiotics. Evaluation of risk factors in patients with Actinomyces bacteremia and further identification of the Actinomyces species are recommended for successful treatment.
Collapse
Affiliation(s)
- Yi-Chun Hsiao
- Department of Internal Medicine, Division of Infectious Diseases, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (Y.-C.H.); (C.-M.H.); (C.-H.T.)
| | - Yi-Hsuan Lee
- Department of Post-Baccalaureate Veterinary Medicine, Asia University, Taichung 41354, Taiwan;
| | - Chun-Mei Ho
- Department of Internal Medicine, Division of Infectious Diseases, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (Y.-C.H.); (C.-M.H.); (C.-H.T.)
| | - Chien-Hao Tseng
- Department of Internal Medicine, Division of Infectious Diseases, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (Y.-C.H.); (C.-M.H.); (C.-H.T.)
| | - Jui-Hsing Wang
- Department of Internal Medicine, Division of Infectious Disease, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 40705, Taiwan
- Department of Internal Medicine, School of Medicine, Buddhist Tzu Chi Medical Foundation Taichung Tzu Chi Hospital, Taichung 427213, Taiwan
- Correspondence:
| |
Collapse
|
38
|
Valeri M, Amato L, Boncompagni M, Ciaccarini R, Del Sordo R, Petrina A. A rare finding of Actinomyces odontolyticus abdominal actinomycosis presenting as abdominal wall and pericolic pseudotumoral mass. Ann Ital Chir 2021; 10:S2239253X21035684. [PMID: 34636341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Abdominal actinomycosis refers to a rare chronic suppurative infectious occurrence, caused by filamentous Gram-positive microaerophilic and anaerobic bacteria Actinomyces, that may appear as an abdominal mass and/or abscess, feasibly mimicking a malignancy 1,2. Due to its rarity and unspecific clinical evidence, the majority of cases are diagnosed after tissue specimen. We hereby report a case of a 69-year-old patient with a one week worsening abdominal pain and swelling. A large tender palpable mass in the epigastric region was noted on physical exam. An ultrasound-guided drainage followed by a surgical excision approach became both a way to confirm the diagnosis and a therapeutic tool. Diagnosis of actinomycosis was made on histopathology and microbiology. Even though the incidence of actinomycosis has decreased, the abdominal presentation has been observed with increasing frequency 3. KEY WORDS: Actinomycosis, Abdominal wall, Abdominal abscess, foreign-body reaction, Colonic neoplasms.
Collapse
|
39
|
Sieniawski K, Kreisel A, Kaczka K, Wierzchniewska-Lawska A, Pomorski L, Smigielski J. Abdominal Wall Actinomycosis Associated with Foreign Body Perforation. Chirurgia (Bucur) 2021; 116:1-5. [PMID: 34463247 DOI: 10.21614/chirurgia.116.ec.1760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 11/23/2022]
Abstract
Abdominal wall actinomycosis is a very rare infection caused by anaerobic Gram-positive bacteria Actinomyces. We present a case of a 72-year-old female with chronic pain located in the right hypochondriac region and anterior abdominal wall mass which had developed six months before. An ultrasonography (USG) and computed tomography (CT) scan of the abdomen were performed and showed an inflammatory change with a strong internal linear reflection in the right upper abdomen. The tumor was located inside the rectus abdominis muscle and connected with internal organs and subcutaneous tissue. The patient qualified for surgery. En block tumor excision was made with partial resection of the transverse colon. Postoperative study revealed fishbone-associated inflammatory actinomycosis tumor. The patient was successfully managed postoperatively with penicillin and discharged on the 11th day after the surgery.
Collapse
|
40
|
Peltenburg SI, Peltenburg JE, van Huisseling H. [Radiological abnormalities and long-term IUD use: think of actinomycosis]. Ned Tijdschr Geneeskd 2021; 165:D5526. [PMID: 34523830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND A rare cause of nonspecific, chronic abdominal pain is actinomycosis. Extensive disease can cause chronic peritonitis mimicking malignancy. CASE DESCRIPTION A 59-year-old women presented with aspecific chronic abdominal pain, after 23 years of IUD use. Imaging showed two solid masses in the abdomen suggestive of malignant disease. Additional diagnostic procedures did not prove malignancy and biopsies showed chronic inflammation. In the absence of proof of malignancy and with regard to the long-term IUD use, actinomycosis was considered. A Pap smear showed Actinomyces 5 years earlier. Antibiotic treatment was instituted and remission of the intra-abdominal masses was seen after six months of treatment. CONCLUSION Consider actinomycosis in a patient presenting with abdominal pain and (long-term) IUD use. Diagnosis is challenging and frequently impossible to confirm before treatment. This diagnosis should be considered after thorough workup for other diseases, especially malignancy. After such analysis, starting antibiotic therapy could prevent secondary complications and invasive procedures.
Collapse
Affiliation(s)
- Sophie I Peltenburg
- HMC Westeinde, afd. Gynaecologie en Verloskunde, Den Haag
- Contact: Sophie I. Peltenburg
| | | | | |
Collapse
|
41
|
Abstract
ABSTRACT A 19-year-old woman in septic shock with recent computed tomography findings of a loculated hepatic abscess was transferred to an intensive care unit where she went into asystolic cardiac arrest. After resuscitation, surgical exploration revealed a purulent pericardial effusion with tamponade and a liver abscess. Microbiological analyses from both sites were negative. Shortly after surgical exploration, she developed multiorgan failure and died. At autopsy, pus was observed both within the pericardial cavity and around the left lobe of the liver. Green "sulfur granules" suggestive of infection with Actinomyces spp. were able to be extruded from the liver during the postmortem examination and cultures returned positive for Actinomyces israelii. This case is a rare example of primary hepatic actinomycosis infection that resulted in the death of a young woman. Nonspecific clinical manifestations may delay diagnosis; however, the finding of "sulfur granules" in areas of abscess formation at autopsy should be taken as an indication of possible underlying Actinomyces infection.
Collapse
Affiliation(s)
- Kelly L Olds
- From the School of Medicine, The University of Notre Dame Australia, Fremantle
| | | | | |
Collapse
|
42
|
Landart C, Trost O, Moizan H. [Atypical actinomycosis revealed by distant dermatological disorders: Report of an unusual case and literature review]. Rev Med Interne 2020; 42:210-213. [PMID: 33303221 DOI: 10.1016/j.revmed.2020.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/15/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Dermatological manifestations of actinomycosis are classical, most often related to Actinomyces israelii. In most of the cases, they occur near to the primary focus, and in the cervicofacial area. Systemic dissemination with cutaneous distant metastasis is rare, most often related to A. israelii, too. We report an original case of upper limb actinomycosis associated with an oral localisation and due to an unusual bacteria. CASE REPORT A 49-year-old man was referred to the Department of dermatology for a skin lesion of the left hand and wrist. Biopsies revealed actinomycosis related to A. meyeri. Dental primary focus was identified and treated. Although the patient was lost sight of, dental eradication and prolonged antibiotics therapy allowed cutaneous improvement. DISCUSSION We report an atypical case of cutaneous actinomycosis due to an Actinomyces meyeri dental infection occurring in an immunocompetent, smoking adult, with poor oral hygiene. The literature review revealed only 4 well-documented cases of cutaneous A. meyeri infections distant to dental primary focus. All of patients were males, immunocompetent, with a history of poor oral hygiene. The prognosis is favourable with adequate treatment (antibiotic therapy and surgical treatment to eradicate dental infectious entry points).
Collapse
Affiliation(s)
- C Landart
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Rouen, université de Rouen Normandie, 1, rue de Germont, 76000 Rouen, France; Centre de soins dentaires, CHU de Rouen, 2, rue Guillaume-Lecointe, 76140 Le Petit-Quevilly, France
| | - O Trost
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Rouen, université de Rouen Normandie, 1, rue de Germont, 76000 Rouen, France; Laboratoire d'anatomie, UFR de santé de Rouen, université de Rouen Normandie, 22, boulevard Léon-Gambetta, 76000 Rouen, France; Inserm, université de Rouen Normandie, université de la Sorbonne, université de Paris 13, Laboratory of medical informatics and knowledge engineering in e-Health, LIMICS, 75006 Paris, France.
| | - H Moizan
- Centre de soins dentaires, CHU de Rouen, 2, rue Guillaume-Lecointe, 76140 Le Petit-Quevilly, France
| |
Collapse
|
43
|
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. Int J Paleopathol 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] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Documented cases of actinomycosis in archaeological skeletons are very rare, especially from Central Europe. Our contribution will help facilitate the differential diagnosis of this disease for other paleopathologists. MATERIAL This paper describes a pathological finding of the skeleton of a 40-year-old male from a burial ground in Sady-Špitálky (Czech Republic) dated to the 10th-12th century. METHODS The affected skeleton was evaluated as a probable case of actinomycosis on the basis of a detailed macroscopic, X-ray and histological examination. The osteolytic foci examined were compared with similar changes caused by tuberculosis, syphilis and mycoses. RESULTS The character and location of the defect on the mandible is indicative of organ actinomycosis and is also reflected by the lytic lesion observed on a lumbar vertebra. CONCLUSIONS The described case can be considered one of the very rare paleopathological findings of possible actinomycosis in humans in Central Europe. SIGNIFICANCE Good evidence of bone actinomycosis findings may be beneficial for further paleopathological and epidemiological studies, especially for research focused on the diachronic development of actinomycosis in Europe. In doing so, all available factors, such as hygiene habits, nutrition, social structure and overall health of the population that could be causally related to its origin, course and treatment, can be taken into account. LIMITATIONS The mandible of the studied individual was damaged, especially in the area affected by the lesion, so the paleopathological analysis was difficult to perform. SUGGESTION FOR THE FUTURE RESEARCH In future, actinomycosis in this skeleton may be confirmed by bio-molecular analysis.
Collapse
Affiliation(s)
- Lenka Vargová
- Division of Medical Anthropology, Department of Anatomy, Faculty of Medicine, Masaryk University, Kamenice 3, 625 00 Brno, Czech Republic.
| | - Ladislava Horáčková
- Division of Medical Sciences in Sports, Department of Kinesiology, Faculty of Sports Studies, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic.
| | - Kateřina Vymazalová
- Division of Medical Anthropology, Department of Anatomy, Faculty of Medicine, Masaryk University, Kamenice 3, 625 00 Brno, Czech Republic.
| | - Alena Němečková
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00, Pilsen, Czech Republic.
| | - Zdeněk Tvrdý
- Anthropos Institute, Moravian Museum, Zelný trh 6, 659 37, Brno, Czech Republic.
| | - Luděk Galuška
- Centre for Slavonic Archaeology, Moravian Museum, Velehradská třída 537, 686 01, Uherské Hradiště, Czech Republic.
| | - Jiří Mitáček
- Moravian Museum, Zelný trh 6, 659 37, Brno, Czech Republic.
| | - Dana Fialová
- Laboratory of Biological and Molecular Anthropology, Department of Experimental Biology, Faculty of Science, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
| |
Collapse
|
44
|
Gilbert L, Miller K, Medeiros D, Tsatoumas M, Ciarallo A, Isabwe G, Malek J, Loo VG, Kumar PN. A disease disregards anatomical planes: actinomycosis and an intrauterine device. Lancet 2020; 396:1766. [PMID: 33248498 DOI: 10.1016/s0140-6736(20)32336-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/14/2020] [Accepted: 10/25/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Lucy Gilbert
- Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, McGill University Health Centre, Montreal, QC, Canada.
| | - Kyle Miller
- Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Diogo Medeiros
- Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Maria Tsatoumas
- Department of Medical Imaging, McGill University Health Centre, Montreal, QC, Canada
| | - Anthony Ciarallo
- Department of Medical Imaging, McGill University Health Centre, Montreal, QC, Canada
| | - Ghislaine Isabwe
- Department of Medicine, Division of Allergy and Clinical Immunology, McGill University Health Centre, Montreal, QC, Canada
| | - Joelle Malek
- Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Vivian G Loo
- Division of Infectious Disease, McGill University Health Centre, Montreal, QC, Canada
| | - Princy N Kumar
- Georgetown University School of Medicine, Department of Medicine, Division of Infectious Diseases and Travel Medicine, Washington, DC, USA
| |
Collapse
|
45
|
Humphrey C, Montoya-Aguilar E, Dorcus M. Pruritic Rash on the Hand of a Home Gardener. Am Fam Physician 2020; 102:497-498. [PMID: 33064431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | | | - Matthew Dorcus
- St. Luke's Family Medicine Residency, Bethlehem, PA, USA
| |
Collapse
|
46
|
Wang W, Ren D, Xu C, Yuan Q, Zhang Q, Hu H, Xie Q. Pulmonary actinomycosis diagnosed by radial endobronchial ultrasound coupled with metagenomic next-generation sequencing: A case report and brief literature review. Int J Infect Dis 2020; 100:379-381. [PMID: 32979589 DOI: 10.1016/j.ijid.2020.09.1418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 09/13/2020] [Accepted: 09/15/2020] [Indexed: 11/19/2022] Open
Abstract
Pulmonary actinomycosis (PA) is an uncommon pulmonary infectious disease that often is misdiagnosed. Metagenomic next-generation sequencing (mNGS) is a highly sensitive and culture-independent new molecular technology for precise infectious disease diagnosis. Here we report a PA case diagnosed by the combination of a radial endobronchial-ultrasonography guide sheath (R-EBUS-GS) and mNGS, along with a brief review of the literature.
Collapse
Affiliation(s)
- Wei Wang
- Endoscopic Center of Chest Medical District, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China; Clinical Center of Nanjing Respiratory Diseases and Imaging, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China; Department of Respiratory Medicine, Chest Medical District, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China.
| | - Dingyu Ren
- Department of Science and Education of Chest Medical District, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Chunhua Xu
- Endoscopic Center of Chest Medical District, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China; Clinical Center of Nanjing Respiratory Diseases and Imaging, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China; Department of Respiratory Medicine, Chest Medical District, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Qi Yuan
- Endoscopic Center of Chest Medical District, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China; Clinical Center of Nanjing Respiratory Diseases and Imaging, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China; Department of Respiratory Medicine, Chest Medical District, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Qian Zhang
- Endoscopic Center of Chest Medical District, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China; Clinical Center of Nanjing Respiratory Diseases and Imaging, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China; Department of Respiratory Medicine, Chest Medical District, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 215 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Huidi Hu
- Department of Pathology, Chest Medical District, Nanjing Brain Hospital Affiliated to NanjingMedical University, 215 Guangzhou Road, Nanjing 210029, China
| | - Qing Xie
- Department of Radiology, Chest Medical District, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 215 Guangzhou Road, Nanjing 210029, China
| |
Collapse
|
47
|
Kasser C, Cholet C, Mahevas T, Mekinian A, Fain O. [Pelvic actinomycosis]. Rev Prat 2020; 70:523. [PMID: 33058639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Camille Kasser
- AP-HP Sorbonne Université, service de médecine interne, hôpital Saint-Antoine, Paris, France
| | - Clément Cholet
- AP-HP Sorbonne Université, service de médecine interne, hôpital Saint-Antoine, Paris, France
| | - Thibault Mahevas
- AP-HP Sorbonne Université, service de médecine interne, hôpital Saint-Antoine, Paris, France
| | - Arsène Mekinian
- AP-HP Sorbonne Université, service de médecine interne, hôpital Saint-Antoine, Paris, France
| | - Olivier Fain
- AP-HP Sorbonne Université, service de médecine interne, hôpital Saint-Antoine, Paris, France
| |
Collapse
|
48
|
Qin J, Chen Y, Xing J, Cai Z. Primary urachal actinomycosis: A literature review. Asian J Surg 2020; 43:575-576. [PMID: 31924416 DOI: 10.1016/j.asjsur.2019.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jiaxuan Qin
- Department of Urology Surgery, The First Affiliated Hospital of Xiamen University; Center of Diagnosis and Treatment of Urinary System Diseases, The First Affiliated Hospital of Xiamen University; The Key Laboratory of Urinary Tract Tumors and Calculi of Xiamen City, The First Affiliated Hospital of Xiamen University. Xiamen, Fujian, 361003, China
| | - Yuedong Chen
- Department of Urology Surgery, The First Affiliated Hospital of Xiamen University; Center of Diagnosis and Treatment of Urinary System Diseases, The First Affiliated Hospital of Xiamen University; The Key Laboratory of Urinary Tract Tumors and Calculi of Xiamen City, The First Affiliated Hospital of Xiamen University. Xiamen, Fujian, 361003, China.
| | - Jinchun Xing
- Department of Urology Surgery, The First Affiliated Hospital of Xiamen University; Center of Diagnosis and Treatment of Urinary System Diseases, The First Affiliated Hospital of Xiamen University; The Key Laboratory of Urinary Tract Tumors and Calculi of Xiamen City, The First Affiliated Hospital of Xiamen University. Xiamen, Fujian, 361003, China.
| | - Zonglong Cai
- The First Clinical Medical School of Fujian Medical University. Xiamen, Fujian, 361003, China
| |
Collapse
|
49
|
Yalav O, Topal U, Ünal AG, Dalci K. Primary actinomycosis of the breast in postmenopausal women. Ann Ital Chir 2019; 8:S2239253X19031232. [PMID: 31869310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Actinomycosis is a chronic infection caused by actinomyces species characterized by an abscess formation, tissue fibrosis, and draining sinuses. Primary actinomycosis of the breast is rare. PATIENTS AND METHODS In this paper we present a 64-year-old postmenopausal woman. For the diagnosis of primary actinomycosis of the breast, mammography, ultrasonography, MRI, and histopathologic examinations are required. Microbiological culture and histopathology are of the most importance during the process of diagnosis. In our case, at the intersection of the sternum and the lower inner quadrant of the right breast, there was a 1 cm wide fistula opening, and an abscess. A. israelii has been isolated from the microbiological culture taken from the lesion RESULTS: An optimal surgical resection of infected tissues has been performed as the treatment with the wound left open for tertiary healing The patient was given sulbactam 4*1 gr/day intravenously for 4 weeks post-op.. Recurrence was not detected during the yearly follow up procedures CONCLUSIONS: Actinomycosis should be considered when differentially diagnosing clinical instances of suppurative or granulomatous infections of the breast and mass regions that can't be ruled out as malignancies. Early diagnosis will save the patient from unnecessary surgical operations and ineffective antibiotic treatments. KEY WORDS Actinomycosis, Breast abscess, Breast diseases.
Collapse
|
50
|
Palm A, Isaksson J, Brandén E, Hillerdal G. [Thoracal actinomycosis - a diagnostic challenge]. Lakartidningen 2019; 116:FR6A. [PMID: 31821519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Actinomycotic infection of the chest structures is rare but can be serious. Diagnosis is difficult, since both culture of the bacterium and pathological investigation require special methods. Investigations therefore usually take many months before the correct treatment can be started. The most common differential diagnosis is a chest malignancy. Treatment is long-term antibiotics. We here present three cases which illustrate the clinical and radiological findings and the diagnostic difficulties.
Collapse
Affiliation(s)
- Andreas Palm
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research - Uppsala, Sweden Department of Medical Sciences, Respiratory, Allergy and Sleep Research - Uppsala, Sweden
| | - Johan Isaksson
- Department of Immunology, Genetics and Pathology, Uppsala University - Uppsala, Sweden Department of Immunology, Genetics and Pathology, Uppsala University - Uppsala, Sweden
| | - Eva Brandén
- Centre for Research and Development,Uppsala University/Region Gävleborg - Gävle, Sweden Centre for Research and Development,Uppsala University/Region Gävleborg - Gävle, Sweden
| | - Gunnar Hillerdal
- Department of Medicine, Gävle Hospital - Gävle, Sweden Department of Medicine, Gävle Hospital - Gävle, Sweden
| |
Collapse
|