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Paediatric Respiratory Reviews Sep 2022Actinomycosis is a rare, indolent and invasive infection caused by Actinomyces species. Actinomycosis develops when there is disruption of the mucosal barrier, and... (Review)
Review
Actinomycosis is a rare, indolent and invasive infection caused by Actinomyces species. Actinomycosis develops when there is disruption of the mucosal barrier, and invasion and systemic spread of the organism, which can lead to endogenous infection affecting numerous organs. It is known to spread in tissue through fascial planes and most often involves the cervicofacial (55%), abdominopelvic (20%) and thoracic (15%) soft tissue. Pulmonary actinomycosis is rare in patients under the age of five years, with the median reported age in the fifth decade. Clinical findings include chest wall mass (49%), cough (40%), pain (back, chest, shoulders) (36%), weight loss (19%), fever (19%), Draining sinuses (15%) and hemoptysis (9%). Chest x-ray findings in pulmonary actinomycosis are mostly nonspecific and can overlap with pulmonary tuberculosis, foreign body aspiration and malignancy. Endobronchial tissue aggregates may show sulphur granules, with yellow to white conglomerate areas of gram positive Actinomyces. Removal or biopsy of these large endobronchial masses must be done with care, because of the risk of bleeding and large airway obstruction. The cytology on bronchoalveolar lavage fluid may show Periodic acid-Schiff (PAS) positive stain, ZN negative and Gram-positive filamentous bacilli which is morphologically suggestive of Actinomycosis. Actinomyces spp is highly susceptible to beta lactam antibiotics, penicillin G, and amoxicillin. A minimum of 3-6 months is needed but up to 20 months of treatment may be needed. Early diagnosis and correct treatment can lead to a good prognosis with a low mortality.
Topics: Humans; Child; Child, Preschool; Periodic Acid; Actinomycosis; Actinomyces; Lung Diseases; Penicillin G; Amoxicillin; Sulfur
PubMed: 34610895
DOI: 10.1016/j.prrv.2021.09.001 -
European Journal of Gastroenterology &... Dec 2021
Topics: Actinomycosis; Heterocyclic Compounds, 3-Ring; Humans
PubMed: 35048664
DOI: 10.1097/MEG.0000000000001899 -
The New England Journal of Medicine Sep 2021
Topics: Abdominal Abscess; Abdominal Pain; Actinomyces; Actinomycosis; Female; Fever; Humans; Intrauterine Devices; Middle Aged; Tomography, X-Ray Computed; Uterus
PubMed: 34469649
DOI: 10.1056/NEJMicm2102632 -
Orvosi Hetilap Jan 2021Összefoglaló. Egy 46 éves nőbeteg esetét ismertetjük, akinél láz és görcsös hasi fájdalom miatt kezdődött kivizsgálás. A hasi ultrahangvizsgálat során...
Összefoglaló. Egy 46 éves nőbeteg esetét ismertetjük, akinél láz és görcsös hasi fájdalom miatt kezdődött kivizsgálás. A hasi ultrahangvizsgálat során a colon transversum területén megvastagodott falú konglomerátum volt látható. A kolonoszkópia során organikus eltérés nem igazolódott. A hasi komputertomográfiás vizsgálat retroperitonealis térfoglalást írt le, ezért onkológiai bizottság javaslata alapján műtét mellett döntöttünk. Egy hónappal a panaszok jelentkezése után megtörtént a műtét, melynek során úgy tűnt, hogy egy megközelítőleg 5 × 8 centiméteres, a vékonybélből kiinduló, a colon ascendenst és a sigmabelet is érintő, daganatnak imponáló terimét találtunk. Jobb oldali hemicolectomiát végeztünk, és reszekáltuk a sigmabélfal részletét. A szövettani vizsgálat malignitást nem igazolt, hanem a bélfallal összefüggést nem mutató, mesenterialis actinomycosist írt le. A hasi, mesenterialis actinomycosis ritka kórkép, mégis fontos, hogy gondoljunk rá mint differenciáldiagnosztikai lehetőségre, így a beteg a lehető leghamarabb megkaphatja a megfelelő kezelést. Esettanulmányunk bemutatásával a kórkép ismeretének fontosságára szeretnénk felhívni a figyelmet. Orv Hetil. 2021; 162(3): 116-119. Summary. We present the case of a 46-year-old female, who presented with fever and abdominal pain. Abdominal ultrasound revealed a thickened-walled conglomerate near the transvers colon. Colonoscopy did not show any organic abnormality. Abdominal computed tomography described a retroperitoneal mass, so we decided on surgery based on the multidisciplinary team decision. One month after the onset of symptoms, laparotomy was performed, and it seemed that we found an approximately 5 × 8 centimetre tumour attached to the small intestine involving the ascending and sigmoid colon. We performed right hemicolectomy and sigmoid colon wall resection. Histology result showed mesenteric actinomycosis with no connection to the intestinal wall, no malignancy was revealed. Although the abdominal, mesenteric actinomycosis is a rare disease, it is important to think of it as a differential diagnostic option, so the patient can get proper treatment and cured sooner. Our aim with presenting this case report is to highlight the significance of this disease. Orv Hetil. 2021; 162(3): 116-119.
Topics: Abdominal Pain; Actinomycosis; Colectomy; Female; Fever; Humans; Middle Aged; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography
PubMed: 33459607
DOI: 10.1556/650.2021.31975 -
Orphanet Journal of Rare Diseases Jun 2023CNS actinomycosis is a rare chronic suppurative infection with non-specific clinical features. Diagnosis is difficult due to its similarity to malignancy, nocardiosis... (Review)
Review
BACKGROUND
CNS actinomycosis is a rare chronic suppurative infection with non-specific clinical features. Diagnosis is difficult due to its similarity to malignancy, nocardiosis and other granulomatous diseases. This systematic review aimed to evaluate the epidemiology, clinical characteristics, diagnostic modalities and treatment outcomes in CNS actinomycosis.
METHODS
The major electronic databases (PubMed, Google Scholar, and Scopus) were searched for the literature review by using distinct keywords: "CNS" or "intracranial" or "brain abscess" or "meningitis" OR "spinal" OR "epidural abscess" and "actinomycosis." All cases with CNS actinomycosis reported between January 1988 to March 2022 were included.
RESULTS
A total of 118 cases of CNS disease were included in the final analysis. The mean age of patients was 44 years, and a significant proportion was male (57%). Actinomycosis israelii was the most prevalent species (41.5%), followed by Actinomyces meyeri (22.6%). Disseminated disease was found in 19.5% of cases. Most commonly involved extra-CNS organs are lung (10.2%) and abdomen (5.1%). Brain abscess (55%) followed by leptomeningeal enhancement (22%) were the most common neuroimaging findings. Culture positivity was found in nearly half of the cases (53.4%). The overall case-fatality rate was 11%. Neurological sequelae were present in 22% of the patients. On multivariate analysis, patients who underwent surgery with antimicrobials had better survival (adjusted OR 0.14, 95% CI 0.04-0.28, p value 0.039) compared to those treated with antimicrobials alone.
CONCLUSION
CNS actinomycosis carries significant morbidity and mortality despite its indolent nature. Early aggressive surgery, along with prolonged antimicrobial treatment is vital to improve outcomes.
Topics: Humans; Male; Adult; Abscess; Actinomycosis; Central Nervous System Diseases; Treatment Outcome
PubMed: 37269006
DOI: 10.1186/s13023-023-02744-z -
Diagnostic Cytopathology Dec 2020
Topics: Actinomyces; Actinomycosis; Aged; Gram-Positive Bacteria; Gram-Positive Bacterial Infections; Humans; Inflammation; Lung; Male
PubMed: 32501649
DOI: 10.1002/dc.24512 -
The New England Journal of Medicine Sep 2018
Topics: Actinomycosis; Humans; Lung Diseases; Male; Middle Aged; Tomography, X-Ray Computed
PubMed: 30207906
DOI: 10.1056/NEJMicm1802090 -
Acta Clinica Belgica Dec 2016In recent years, it has become apparent that Tropheryma whipplei not only causes a chronic multisystemic infection which is often preceded by arthropathies for many... (Review)
Review
In recent years, it has become apparent that Tropheryma whipplei not only causes a chronic multisystemic infection which is often preceded by arthropathies for many years, well known as 'classical' Whipple's disease, but also clinically becomes manifest with localized organ affections and acute (transient) infections in children. T. whipplei is found ubiquitously in the environment and colonizes in some healthy carriers. In this review, we highlight new aspects of this enigmatic infectious disorder.
Topics: Anti-Bacterial Agents; Humans; Tropheryma; Whipple Disease
PubMed: 27884091
DOI: 10.1080/17843286.2016.1256586 -
Atencion Primaria Oct 2020
Topics: Abdominal Wall; Actinomycosis; Anti-Bacterial Agents; Humans
PubMed: 32576382
DOI: 10.1016/j.aprim.2020.04.009 -
Obstetrical & Gynecological Survey Apr 2017is commonly found in many areas of the body where it derives a benefit without harming the host. When it does infect the host during pregnancy, is that infection a... (Review)
Review
IMPORTANCE
is commonly found in many areas of the body where it derives a benefit without harming the host. When it does infect the host during pregnancy, is that infection a threat to the obstetric patient and does that infection cause adverse pregnancy outcomes?
OBJECTIVE
The aim of this study was to review what is known about infections and the impact of an infection on pregnancy outcomes.
EVIDENCE ACQUISITION
A PubMed search was undertaken with the search years unlimited to April 1, 2016, and restricted to articles in English. The search terms included "actinomyces," "pregnancy," "prenatal," "maternal," "actinomyces infection," "pregnancy," "chorioamnionitis," "preterm labor," "premature birth," or "postpartum actinomyces."
RESULTS
Eighteen of the 154 identified articles are the basis of this review. is a rod-like positive bacterium. The diagnosis of an infection can be by culture or Gram stain. is commensal and typically only infects after a mucosal break or lesion. Seventeen cases were identified in pregnancy. Ten cases were complicated by chorioamnionitis and a preterm delivery. A nidus leading to infection was identified in 12 of the cases including women with a cervical cerclage, dental abscesses, appendicitis, renal actinomycosis, and ovarian abscesses. Adverse pregnancy outcomes have been linked with periodontal disease, but treatment did not prevent preterm delivery in a randomized, blinded, controlled trial.
CONCLUSIONS
infections in pregnancy are rare but, if they occur, have been linked primarily with preterm deliveries.
TARGET AUDIENCE
Obstetricians and gynecologists, family physicians.
LEARNING OBJECTIVES
After completing this activity, the learner should be better able to identify the areas of the body where infections occur and how the infections typically occur, identify the pathophysiologic changes that occur during pregnancy that might lead to an infection and how that infection may affect pregnancy outcomes, and describe the treatment for mild and severe infections.
Topics: Actinomyces; Actinomycosis; Chorioamnionitis; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Premature Birth
PubMed: 28426126
DOI: 10.1097/OGX.0000000000000423