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Journal of Indian Association of... 2023Pulmonary actinomycosis is an extremely rare disease in children. The diagnosis is challenging as the clinical presentation and radiological investigations may be...
Pulmonary actinomycosis is an extremely rare disease in children. The diagnosis is challenging as the clinical presentation and radiological investigations may be atypical. We report a case of a pulmonary lesion extending to the chest wall posing as a malignant lesion. Biopsy revealed colonies of . Antibiotic therapy resolved the mass. A rare diagnosis of pulmonary actinomycosis should be kept as a differential diagnosis of such a mass in children.
PubMed: 38173643
DOI: 10.4103/jiaps.jiaps_86_23 -
Japanese Journal of Radiology Apr 2024This review focuses on inflammatory diseases of female and male genital organs and discusses their epidemiology, pathogenesis, clinical presentation, and imaging... (Review)
Review
This review focuses on inflammatory diseases of female and male genital organs and discusses their epidemiology, pathogenesis, clinical presentation, and imaging findings. The female section covers pelvic inflammatory disease (PID) primarily caused by sexually transmitted infections (STIs) that affect the uterus, fallopian tubes, and ovaries. Unusual causes such as actinomycosis and tuberculosis have also been explored. The male section delves into infections affecting the vas deferens, epididymis, testes, prostate, and seminal vesicles. Uncommon causes such as tuberculosis, and Zinner syndrome have also been discussed. In addition, this review highlights other conditions that mimic male genital tract infections such as vasculitis, IgG4-related diseases, and sarcoidosis. Accurate diagnosis and appropriate management of these inflammatory diseases are essential for preventing serious complications and infertility. Imaging modalities such as ultrasound, magnetic resonance imaging, and computed tomography play a crucial role in diagnosis. Understanding the diverse etiologies and imaging findings is vital for the effective management of inflammatory diseases of the genital organs.
Topics: Male; Humans; Female; Pelvic Inflammatory Disease; Genitalia; Uterus; Prostate; Tuberculosis
PubMed: 38165529
DOI: 10.1007/s11604-023-01518-8 -
The Journal of Infection Feb 2024Tropheryma whipplei infection can manifest as inflammatory joint symptoms, which can lead to misdiagnosis of inflammatory rheumatic disease and the use of...
OBJECTIVES
Tropheryma whipplei infection can manifest as inflammatory joint symptoms, which can lead to misdiagnosis of inflammatory rheumatic disease and the use of disease-modifying antirheumatic drugs. We investigated the impact of diagnosis and treatment of Tropheryma whipplei infection in patients with inflammatory rheumatic disease.
METHODS
We initiated a registry including patients with disease-modifying antirheumatic drugs-treated inflammatory rheumatic disease who were subsequently diagnosed with Tropheryma whipplei infection. We collected clinical, biological, treatment data of the inflammatory rheumatic disease, of Tropheryma whipplei infection, and impact of antibiotics on the evolution of inflammatory rheumatic disease.
RESULTS
Among 73 inflammatory rheumatic disease patients, disease-modifying antirheumatic drugs initiation triggered extra-articular manifestations in 27% and resulted in stabilisation (51%), worsening (34%), or improvement (15%) of inflammatory rheumatic disease. At the diagnosis of Tropheryma whipplei infection, all patients had rheumatological symptoms (mean age 58 years, median inflammatory rheumatic disease duration 79 months), 84% had extra-rheumatological manifestations, 93% had elevated C-reactive protein, and 86% had hypoalbuminemia. Treatment of Tropheryma whipplei infection consisted mainly of doxycycline plus hydroxychloroquine, leading to remission of Tropheryma whipplei infection in 79% of cases. Antibiotic treatment of Tropheryma whipplei infection was associated with remission of inflammatory rheumatic disease in 93% of cases and enabled disease-modifying antirheumatic drugs and glucocorticoid discontinuation in most cases.
CONCLUSIONS
Tropheryma whipplei infection should be considered in inflammatory rheumatic disease patients with extra-articular manifestations, elevated C-reactive protein, and/or hypoalbuminemia before disease-modifying antirheumatic drugs initiation or in inflammatory rheumatic disease patients with an inadequate response to one or more disease-modifying antirheumatic drugs. Positive results of screening and diagnostic tests for Tropheryma whipplei infection involve antibiotic treatment, which is associated with complete recovery of Tropheryma whipplei infection and rapid remission of inflammatory rheumatic disease, allowing disease-modifying antirheumatic drugs and glucocorticoid discontinuation.
Topics: Humans; Middle Aged; Tropheryma; Glucocorticoids; C-Reactive Protein; Hypoalbuminemia; Anti-Bacterial Agents; Rheumatic Diseases; Antirheumatic Agents; Whipple Disease
PubMed: 38141787
DOI: 10.1016/j.jinf.2023.12.010 -
Microorganisms Dec 2023Actinomycosis represents a challenging and under-reported complication of vascular surgery. Optimal management of spp. prosthetic vascular graft infection (PVGI) is... (Review)
Review
BACKGROUND
Actinomycosis represents a challenging and under-reported complication of vascular surgery. Optimal management of spp. prosthetic vascular graft infection (PVGI) is highly uncertain because of the paucity of reports on this disease.
METHODS
We conducted a retrospective case-series of -PVGI that occurred in the last five years in two major university hospitals in northern Italy. We searched for previously published cases in the scientific literature.
RESULTS
We report five original cases of spp. prosthetic vascular graft infection following aortic aneurysm repair. Our literature review retrieved eight similar cases. Most patients were immunocompetent males. Most infections were polymicrobial (11/13 cases), with a prevalence of involvement (3/13 cases were associated with. spp. infection). All cases had a late presentation (≥4 months from graft placement), with 61% associated with an aorto-enteric fistula. All patients received antibiotic therapy, but the duration was highly heterogeneous (from two weeks to life-long antibiotics). The patients without surgical revision experienced septic recurrences (2/13), permanent dysfunction (1/13), or a fatal outcome (2/13), while of the remainder who underwent vascular graft explant, six recovered completely and one developed a periprosthetic abscess. In two cases follow-up was not available.
CONCLUSIONS
This case-series aims to raise the diagnostic suspicion and to describe the current management of -PVGIs. We highlight a high heterogeneity in antibiotic duration, choice of the antibiotic regimen, and surgical management. Higher reporting rate is advisable to produce better evidence and optimize management of this rare complication of vascular surgery.
PubMed: 38138076
DOI: 10.3390/microorganisms11122931 -
International Journal of Paleopathology Mar 2024The purpose of this article is to try to determine the probable cause of the disease from which the study animal suffered.
OBJECTIVE
The purpose of this article is to try to determine the probable cause of the disease from which the study animal suffered.
MATERIALS
The skeletal material included a caudal fragment of a cattle mandible. The specimen, exhibiting chronic disease was separated from approximately 10,000 early medieval cattle remains discovered during excavations of the former Kruszwica stronghold.
METHODS
The bone was underwent macroscopic, radiological and histopathological examination.
RESULTS
Location, macroscopic, microscopic and X-ray images of the lesions within the examined mandible indicate it could have been caused by the actinomycosis.
CONCLUSIONS
In the face of infection, no effective therapies were undertaken in the Middle Ages.
SIGNIFICANCE
Descriptions of lumpy jaw in the paleopathological literature are rare. This disease, due to its background and course, eliminated animals from breeding for centuries until the era of antibiotics. The case described in our paper is in an advanced stage, but its adult age suggests that efforts were possibly made to keep the cow alive as long as possible, indicating the significant economic importance of the animal.
LIMITATIONS
This analysis is limited by the absence of other anatomical elements of the affected animal, which impacts the interpretation of the palaeopathological bone.
SUGGESTIONS FOR FURTHER RESEARCH
It is recommended that similar studies are conducted on better preserved and more numerous cattle assemblages.
Topics: Female; Cattle; Animals; Poland; Radiography; Mandible
PubMed: 38134631
DOI: 10.1016/j.ijpp.2023.11.006 -
Infection and Drug Resistance 2023A 66-year-old male patient diagnosed with small-cell lung cancer received chemotherapy and immunotherapy, resulting in successful tumor control. However, the patient...
A 66-year-old male patient diagnosed with small-cell lung cancer received chemotherapy and immunotherapy, resulting in successful tumor control. However, the patient subsequently experienced a fever and rapid progression of the pulmonary cavity. Despite sampling bronchoscopic bronchoalveolar lavage fluid for targeted next-generation sequencing (tNGS), the cause remained unidentified. Adding bronchoalveolar lavage fluid to sense metagenomic next-generation sequencing (mNGS) confirmed the infection caused by actinomycetes. The patient's condition improved after active anti-infection treatment. This case was further analyzed and discussed through a comprehensive literature review, focusing on molecular microbiological diagnosis and treatment processes. The points outlined were as follows: the advancement of molecular microbiology has gradually reduced the challenges associated with diagnosing rare infectious diseases such as pulmonary actinomycosis. Additionally, in immunodeficient individuals, certain infectious diseases with a chronic course may exhibit acute and aggressive characteristics, which is of concern to all colleagues. Currently, tNGS and mNGS are widely employed in clinical settings as practical tools for diagnosing infectious diseases. Notably, these two methods are not substitutes for each other but complement each other.
PubMed: 38107432
DOI: 10.2147/IDR.S429699 -
European Journal of Internal Medicine Mar 2024Whipple's disease, an extremely rare, chronic infection caused by Tropheryma whipplei, an actinobacterium ubiquitously present in the environment, is a multisystemic... (Review)
Review
Whipple's disease, an extremely rare, chronic infection caused by Tropheryma whipplei, an actinobacterium ubiquitously present in the environment, is a multisystemic condition that can affect several organs. Therefore, Whipple's disease should always be considered by physicians working across various branches of medicine, including internal medicine, rheumatology, infectious diseases, gastroenterology, haematology, and neurology. Initially, Whipple's disease is challenging to diagnose due to both its rarity and non-specific clinical features, almost indistinguishable from rheumatological conditions. A few years later, the onset of gastrointestinal symptoms increases the specificity of its clinical picture and helps in reaching the correct diagnosis. Diagnosis is typically made by finding PAS-positive macrophages in the lamina propria at duodenal biopsy. PCR for Tropheryma whipplei is nowadays also increasingly available, and represents an undeniable help in diagnosing this condition. However, it may also be misleading as false positives can occur. If not promptly recognized and treated, central nervous system involvement may develop, which can be fatal. The therapeutic gold standard has not yet been fully established, particularly in cases of recurrent disease, neurological involvement, and an immune reconstitution inflammatory syndrome that may arise following the initiation of antibiotic therapy.
Topics: Humans; Whipple Disease; Rare Diseases; Anti-Bacterial Agents; Biopsy; Tropheryma; Physicians
PubMed: 38105122
DOI: 10.1016/j.ejim.2023.12.009 -
Journal of Investigative Medicine High... 2023Individuals 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... (Review)
Review
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.
Topics: Humans; Actinomycosis; COVID-19; Maxillary Sinusitis
PubMed: 38102073
DOI: 10.1177/23247096231217823 -
BMJ Case Reports Dec 2023
Topics: Humans; Actinomycosis, Cervicofacial; Diagnosis, Differential; Actinomycosis
PubMed: 38087483
DOI: 10.1136/bcr-2023-258129 -
Indian Journal of Pathology &... 2023COVID-19 caused by SARS-CoV-2 has been studied and reported widely since November 2019, after its first case was detected in Wuhan, China. It has proven to be a fatal...
COVID-19 caused by SARS-CoV-2 has been studied and reported widely since November 2019, after its first case was detected in Wuhan, China. It has proven to be a fatal disease worldwide. COVID-19 causes severe disease in patients with immunosuppression and has always been associated with high mortality in such patients. Immunocompromised patients are always at a higher risk of getting co-infections too, and the same is true with COVID-19. It predisposes to the development of many fungal infections of which, mucormycosis is one of the most common ones, especially in the Indian population where a large group of the population is predisposed to diabetes mellitus. India has the world's largest population of diabetic patients; therefore, the prevalence of COVID-19-associated mucormycosis (CAM) is also the highest in India. Also, the use of corticosteroids over a long duration of time predisposes the patients to the development of mucormycosis owing to immunosuppression. Hypoxia, low total leukocyte count, and high ferritin are the other predisposing factors that lead to the growth of mucormycosis associated with COVID-19. Here, we present five cases within a span of 2 months, of mucormycosis-associated COVID-19 with mixed infections of aspergillosis and actinomycetes. Four cases had mucormycosis with aspergillosis and one with mucormycosis with Actinomyces. Three patients recovered fully after being treated with intravenous amphotericin B; however, unfortunately, two of our patients could not be saved.
Topics: Humans; Mucormycosis; COVID-19; SARS-CoV-2; Fungi; Aspergillosis; Invasive Fungal Infections; Actinomycosis; Coinfection
PubMed: 38084540
DOI: 10.4103/ijpm.ijpm_507_22