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BMJ Case Reports Apr 2021A 33-year-old man without significant medical history presented to the emergency department with a 6-month history of fatigue and 30 pounds of unintentional weight loss,...
A 33-year-old man without significant medical history presented to the emergency department with a 6-month history of fatigue and 30 pounds of unintentional weight loss, with a recent cough and fever over the past week. He recalled two similar illnesses during college that did not require medical care. He denied tobacco use but reported inhaling marijuana 1-2 times daily over the past year with a vaping device. Physical exam was notable for a temperature of 100.0°F and an elevated blood pressure at 161/77 mm Hg. He was diaphoretic with clear breath sounds bilaterally. Chest imaging revealed diffuse ground glass opacities with subpleural sparing and mildly enlarged hilar lymph nodes. Bronchoscopy with transbronchial lung biopsies and needle aspirate of lymph nodes revealed organising pneumonia, and subsequent cultures grew He was treated with amoxicillin and corticosteroids with subsequent resolution on repeat chest imaging.
Topics: Actinomycosis; Adult; Cannabis; Cough; Humans; Lung Diseases; Male; Vaping
PubMed: 33795280
DOI: 10.1136/bcr-2020-240973 -
Indian Journal of Dermatology,... 2018
Topics: Actinomycosis; HIV Infections; Humans; Osteomyelitis
PubMed: 29451191
DOI: 10.4103/ijdvl.IJDVL_516_17 -
Journal of General Internal Medicine Feb 2015
Topics: Actinomycosis, Cervicofacial; Amoxicillin; Female; Humans; Middle Aged
PubMed: 25280832
DOI: 10.1007/s11606-014-3001-z -
Revista Da Associacao Medica Brasileira... Mar 2022Pulmonary actinomycosis, clinically and radiologically, mimics abscess, tuberculosis, and lung malignancy, resulting in misdiagnosis or delay in diagnosis. In this...
INTRODUCTION
Pulmonary actinomycosis, clinically and radiologically, mimics abscess, tuberculosis, and lung malignancy, resulting in misdiagnosis or delay in diagnosis. In this study, we analyzed the clinicoradiological features of pulmonary actinomycosis, the presence of any differences between clinical prediagnosis and radiological diagnosis, and whether imaging modalities help distinguish pulmonary actinomycosis from lung cancer.
METHODS
A total of 22 patients who had a histopathological diagnosis of actinomycosis in a tertiary health center participated in this study. Of these, 14 had positron-emission tomography/computed tomography.
RESULTS
In all, 81.8% of the patients were males. The diagnostic procedures employed for the diagnosis of actinomycosis were surgery in 54.5% of patients, fiberoptic bronchoscopy in 36.4% of patients, and rigid bronchoscopy in 9.1% of patients. Radiological and clinical prediagnosis showed malignancy in 31.8 and 40.9% of patients, respectively. The mean of the maximum standardized uptake value was 6.33±3.6 on positron-emission tomography/computed tomography. Kappa compliance analysis revealed that clinical and radiological diagnoses were significantly compatible with each other and that radiological pre-diagnoses were not superior to clinical diagnoses (κ=0.701 and p<0.001).
CONCLUSION
Pulmonary actinomycosis shows high metabolic uptake in positron-emission tomography/computed tomography, and this may mislead clinicians for a diagnosis of malignancy. Our results suggest that positron-emission tomography/computed tomography does not help distinguish pulmonary actinomycosis from lung malignancy and does not provide a clear diagnostic benefit to the clinician, so pathological diagnosis is necessary.
Topics: Actinomycosis; Bronchoscopy; Diagnosis, Differential; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Radiography
PubMed: 35442366
DOI: 10.1590/1806-9282.20211017 -
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 -
Nigerian Journal of Clinical Practice Oct 2022An extremely rare disease with a slow course, actinomycosis has a high mortality risk when not properly treated. Pulmonary actinomycosis is clinically and radiologically...
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.
Topics: Male; Humans; Aged; Actinomycosis; Lung Diseases; Lung; Anti-Bacterial Agents; Sulfur
PubMed: 36308251
DOI: 10.4103/njcp.njcp_1357_21 -
European Review For Medical and... Nov 2022Pulmonary actinomycosis is a rare and chronic infectious disease that mimics malignancy and is frequently misdiagnosed. There are few reports that address the clinical...
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.
Topics: Humans; Adult; Middle Aged; Aged; Positron Emission Tomography Computed Tomography; Retrospective Studies; Actinomycosis; Lung Diseases; Lung Neoplasms; Treatment Outcome; Anti-Bacterial Agents
PubMed: 36394726
DOI: 10.26355/eurrev_202211_30160 -
Cureus Sep 2023Actinomycosis is a progressive granulomatous infection caused by the bacteria . Classically, the three most common clinical forms are cervicofacial, thoracic, and...
Actinomycosis is a progressive granulomatous infection caused by the bacteria . Classically, the three most common clinical forms are cervicofacial, thoracic, and abdominopelvic. On the contrary, nasopharyngeal actinomycosis is considered to be a rare clinical disease, and its occurrence is extremely low. The infection can take place without any preceding infection or on immunocompromised status. A 25-year-old male with no previous medical history presented with persistent nasal congestion and rhinorrhea. A nasal endoscopy examination revealed an unclearly demarcated nasopharyngeal mass, and a complete microbiology and pathology analysis showed actinomycetes colonies. After two weeks of oral Augmentin therapy, the patient's illness was completely eradicated. Diagnosis of nasopharyngeal actinomycosis is exceptionally crucial, and with early treatment of appropriate antibiotic therapy, the prognosis is excellent. Careful follow-up after adequate treatment as the possibility of frequent relapse is common.
PubMed: 37868511
DOI: 10.7759/cureus.45710 -
Acta Gastro-enterologica Belgica 2018
Topics: Actinomycosis; Aged, 80 and over; Colonic Neoplasms; Diabetes Mellitus, Type 2; Diagnosis, Differential; Female; Humans; Hypertension; Intestinal Diseases; Tomography, X-Ray Computed
PubMed: 30024715
DOI: No ID Found -
BMJ Case Reports Nov 2014Actinomycosis of the kidney is rare and less than 50 cases have been reported in the English literature. Reported presentations are pyelonephritis, renal abscesses or...
Actinomycosis of the kidney is rare and less than 50 cases have been reported in the English literature. Reported presentations are pyelonephritis, renal abscesses or pyonephrosis. To date, one case of actinomycosis associated necrotising papillitis has been reported. We describe the second case of such a rare association of actinomycosis with papillary necrosis.
Topics: Actinomyces; Actinomycosis; Humans; Inflammation; Kidney; Kidney Medulla; Kidney Papillary Necrosis; Male; Middle Aged
PubMed: 25406215
DOI: 10.1136/bcr-2014-205892