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Polish Archives of Internal Medicine Jun 2024
Topics: Humans; Diagnosis, Differential; Actinomycosis; Hernia, Umbilical; Abdominal Neoplasms; Male; Female; Middle Aged
PubMed: 38656084
DOI: 10.20452/pamw.16736 -
Pediatrics May 2024Esophageal stenosis can cause vomiting or dysphagia in children and is commonly treated with esophageal balloon dilation. However, surgery may be required if the...
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.
Topics: Humans; Male; Esophageal Stenosis; Actinomycosis; Child, Preschool; Amoxicillin; Anti-Bacterial Agents; Penicillin G
PubMed: 38655638
DOI: 10.1542/peds.2023-062823 -
SAGE Open Medical Case Reports 2024Actinomycosis, a rare chronic bacterial infection caused by Actinomyces species, presents diagnostic challenges due to diverse clinical presentations. This report...
Actinomycosis, a rare chronic bacterial infection caused by Actinomyces species, presents diagnostic challenges due to diverse clinical presentations. This report presents a case of peritoneal actinomycosis incidentally discovered during a total abdominal hysterectomy in a 44-year-old female with refractory abnormal uterine bleeding and a history of long-term intrauterine contraceptive device use. The patient presented with persistent abnormal uterine bleeding despite conservative management. Intraoperative findings during total abdominal hysterectomy revealed peritoneal involvement, prompting histopathological evaluation confirming actinomycosis. This case highlights diagnostic complexities associated with actinomycosis, emphasizing the significance of histopathological confirmation. Postoperative management with antibiotics demonstrated favorable outcomes, supporting their efficacy in treating actinomycosis. The case underscores the importance of considering uncommon infections in pelvic pathology, particularly in patients with prolonged intrauterine contraceptive device usage. It prompts further exploration of actinomycosis in relation to intrauterine contraceptive device use and highlights the need for timely intervention and histopathological confirmation for optimal patient care.
PubMed: 38655125
DOI: 10.1177/2050313X241248389 -
The Journal of the Royal College of... Mar 2024Whipple's disease is a multisystemic chronic infectious condition caused by (). Though characterised often by insidious weight loss, diarrhoea, and arthralgia, three...
Whipple's disease is a multisystemic chronic infectious condition caused by (). Though characterised often by insidious weight loss, diarrhoea, and arthralgia, three other distinct manifestations can be observed, namely localised disease, acute infection and asymptomatic carriage. The diagnosis relies on histopathological examination of duodenal biopsies and polymerase chain reaction analysis of the 16S rRNA gene for We report the case of a middle-aged man admitted for etiologic investigation of prolonged, migrating, and inflammatory arthralgias and subsequent development of gastrointestinal symptoms. Despite its reputation as a great mimicker of many different illnesses, the difficulty in diagnosis probably lies with its rarity rather than its masking.
Topics: Male; Middle Aged; Humans; Anti-Bacterial Agents; Whipple Disease; Rare Diseases; RNA, Ribosomal, 16S; Biopsy
PubMed: 38606805
DOI: 10.1177/14782715241237283 -
Journal of Surgical Case Reports Apr 2024Actinomycosis remains a rare and often underdiagnosed cause of appendicitis with only 10% of cases diagnosed prior to surgery. It is an important cause to consider...
Actinomycosis remains a rare and often underdiagnosed cause of appendicitis with only 10% of cases diagnosed prior to surgery. It is an important cause to consider particularly in the setting of an indolent infection with nonspecific symptoms. We present a 22 years old male who presented with 3 weeks history of lower abdominal pain who underwent laboratory investigations and imaging studies suggestive of acute appendicitis. He underwent an emergency laparoscopic caecectomy with histopathology of the specimen suggestive of actinomycosis. He recovered well postoperatively and was discharged home with a prolonged course of oral penicillins. Preoperative diagnosis of actinomycosis is uncommon and accounts for ~10% of cases. Definitive diagnosis is usually through histopathology or tissue/fluid culture. Treatment usually involves a combination of surgical resection and antibiotic therapy with a success rate of >90%.
PubMed: 38572291
DOI: 10.1093/jscr/rjae195 -
Medicina Clinica May 2024This study aims to assess the clinical, radiological, and histological characteristics of Actinomyces infection identified in appendectomy specimens.
OBJECTIVE
This study aims to assess the clinical, radiological, and histological characteristics of Actinomyces infection identified in appendectomy specimens.
MATERIAL AND METHODS
Between January 2013 and November 2023, 5834 patients underwent appendectomy in our clinic, and their pathology reports were retrospectively reviewed.
RESULTS
Actinomyces appendicites were reported in 14 specimens (0.23%). It was determined that appendectomy was performed in only 10 patients (71.4%), ileocecal resection was performed in two patients (14.2%) and right hemicolectomy in two patients (14.2%). The operations on five patients were performed by laparoscopy, and the operations on the other nine patients were performed by open surgery. Laparoscopy was started in three patients and converted to open surgery due to suspicion of an ileocecal mass and cecal perforation. It was found that the white blood cell count of three patients was within the normal range of reference (8-9.77mg/dL); leukocytosis was detected in other patients (10.2-18.7mg/dL). C-reactive protein was normal in one patient and high in the rest of the patients. While the first-hour erythrocyte sedimentation rate was normal in five patients, it was found to be high in the other patients. Findings on radiological imaging were reported as acute appendicitis, appendicular plastron, and ileocecal mass. As a result of the pathology findings, the patients were given oral penicillin or semi-synthetic penicillin derivatives during one month.
CONCLUSION
Ileocecal and appendecular actinomycosis are rare, and preoperative diagnosis is difficult. A definitive diagnosis is usually made after a histopathological examination. After surgery, long-term antimicrobial treatment of the patient is possible with penicillin.
Topics: Humans; Actinomycosis; Male; Female; Retrospective Studies; Middle Aged; Adult; Appendectomy; Aged; Appendicitis; Young Adult; Cecal Diseases; Laparoscopy; Actinomyces; Adolescent
PubMed: 38570296
DOI: 10.1016/j.medcli.2024.02.005 -
The Pediatric Infectious Disease Journal Apr 2024Pediatric actinomycosis studies are limited to case reports or small case series. In this retrospective cohort study, we aimed to describe characteristics of skin and...
BACKGROUND
Pediatric actinomycosis studies are limited to case reports or small case series. In this retrospective cohort study, we aimed to describe characteristics of skin and soft tissue actinomycosis in adolescents and children.
METHODS
We conducted the study from January 2019 to December 2022, including patients aged ≤21 years with at least 1-year follow-up data. All clinical cultures obtained under sterile conditions with Actinomyces growth were included.
RESULTS
One hundred four patients met inclusion criteria; median age 19 (interquartile range: 17-20) years, 68.3% female, 46.2% Black and 47.1% Hispanic. The median antibiotic treatment duration was 10 (7-10) days, and majority of patients received treatment with non-first-line Actinomyces antibiotics. Infectious disease consultation was requested for only 7 patients during their initial skin and soft tissue actinomycosis treatment. One-third of the patients with skin and soft tissue actinomycosis had documented recurrence within a median of 10 (interquartile range: 6-16) months of the initial episode. Monobacterial culture growth (85.7% vs. 63.8%, P = 0.02), patients with body mass index >25 (75% vs. 52.6%, P = 0.04) and patients with prior abscess in the same area (18.8% vs. 51.4%, P = 0.001) were significantly higher in patients with recurrent actinomycosis compared to the nonrecurrent group. In a univariate logistic regression model, they were found to be significantly associated with recurrence; monobacterial growth [odds ratio (OR): 3.4; 95% confidence interval (CI): 1.2-9.9], body mass index >25 (OR: 2.7; 95% CI, 1.1-7.0) and prior abscess (OR: 4.6; 95% CI: 1.9-11.2).
CONCLUSIONS
Our study results highlight the importance of considering Actinomyces species in skin and soft tissue infections, especially in recurrent ones, and risk factors for recurrence. Suboptimal antibiotic utilization, very low numbers of consultations with infectious diseases and high recurrence rate suggest that providers should be informed and updated regarding this rare but hard-to-treat infection.
PubMed: 38564739
DOI: 10.1097/INF.0000000000004345 -
Indian Journal of Medical Microbiology 2024Actinomycosis is a rare infection caused by Actinomyces spp. Of all actinomycosis infections, only 5% of Hepatic Actinomycosis (HA) infection has been reported. This...
Actinomycosis is a rare infection caused by Actinomyces spp. Of all actinomycosis infections, only 5% of Hepatic Actinomycosis (HA) infection has been reported. This disease is often misdiagnosed as a malignancy. This case report presents a 45-year-old woman with diabetes, initially suspected of intrahepatic cholangiocarcinoma, but after careful tissue staining, we found the results supported HA infection.
Topics: Humans; Actinomycosis; Female; Middle Aged; Actinomyces; Liver; Liver Diseases; Histocytochemistry; Tomography, X-Ray Computed
PubMed: 38556249
DOI: 10.1016/j.ijmmb.2024.100573 -
International Journal of Infectious... Jun 2024
Topics: Humans; Lymphadenopathy; Tropheryma; Whipple Disease; Male; Anti-Bacterial Agents; Middle Aged
PubMed: 38556042
DOI: 10.1016/j.ijid.2024.107033 -
Respiratory Medicine Case Reports 2024A 52-year-old female patient receiving olaparib maintenance treatment was admitted to hospital with a low fever and chest tightness. A CT scan of the patient's chest...
A 52-year-old female patient receiving olaparib maintenance treatment was admitted to hospital with a low fever and chest tightness. A CT scan of the patient's chest showed diffuse ground glass shadow or miliary nodular shadow in the bilateral lungs. Her inflammatory biomarkers were almost normal, except the slightly elevated C-reactive protein. Moreover, lymphocytes count obviously decreased. Empirical treatment did not relieve her symptoms, while traditional testing developed negative results. The results of metagenomic next-generation sequencing (mNGS) revealed the presence of a potential pathogen, Actinomyces odontolyticus (A. odontolyticus), in bronchoalveolar lavage fluid (BLAF). Once large-dosed penicillin G was administered, the fever returned to normal and chest tightness disappeared. Reexamination of chest CT revealed that the pulmonary lesions was almost absorbed. Our case demonstrated that mNGS is a novel approach to identify pathogens sensitively and accurately, especially for uncommon and atypical infection.
PubMed: 38550310
DOI: 10.1016/j.rmcr.2024.102007