-
Cureus Aug 2023Actinomycosis is a chronic, indolent, granulomatous disease process caused by the genus of bacteria. More severe forms of actinomycosis include disseminated or central...
Actinomycosis is a chronic, indolent, granulomatous disease process caused by the genus of bacteria. More severe forms of actinomycosis include disseminated or central nervous system (CNS) infections. is the most common species of isolated from brain abscesses. species is commonly associated with skin and soft tissue abscesses. However, it rarely causes brain abscesses. We present an unusual case of brain abscess in a 69-year-old female who presented with acute encephalopathy and bilateral lower extremity weakness. She was diagnosed with left-sided mastoiditis with intracranial extension, left posterior fossa epidural abscess, and transverse sinus thrombosis. The patient's hospital course was complicated by hydrocephalus and declining neurological status. Empiric antimicrobial therapy was initiated, and the patient underwent mastoidectomy and external ventricular drain placement followed by decompression craniotomy and subarachnoid abscess aspiration. Given her poor and unchanged neurologic status, the patient was transitioned to comfort-oriented measures after shared decision-making with the family. It is crucial to identify as a causal agent of severe CNS infections like brain abscesses, meningoencephalitis, or subdural empyema, as untreated infections can lead to irreversible neurologic complications.
PubMed: 37664255
DOI: 10.7759/cureus.42868 -
IDCases 2023Necrotizing fasciitis is a type of necrotizing soft tissue infection (NSTI) that can be polymicrobial or monomicrobial in origin. Polymicrobial infections typically...
Necrotizing fasciitis is a type of necrotizing soft tissue infection (NSTI) that can be polymicrobial or monomicrobial in origin. Polymicrobial infections typically involve anaerobes of the Clostridium or Bacteroides family. This case report highlights necrotizing fasciitis caused by an unusual culprit, , which is a gram-positive anaerobic filamentous bacillus that has only been documented in one prior report to cause NSTI. Currently, about half of the hospitals in the United States are equipped to perform antibiotic susceptibility testing for anaerobes, but less than one-quarter of hospitals actually utilize these tests routinely. Thus, it is common for polymicrobial actinomycoses to be blindly treated with antibiotics that are beta-lactamase resistant and active against anaerobes, such as with piperacillin-tazobactam. Here we examine the potential impact of this lack of testing, as well as the evolution of to cause necrotizing fasciitis.
PubMed: 36845908
DOI: 10.1016/j.idcr.2023.e01712 -
Infectious Diseases and Therapy Mar 2023Fournier's gangrene (FG) is a rare infectious disease with rapid disease progression and a high mortality rate. We report a case of a 61-year-old female with type 2...
Fournier's gangrene (FG) is a rare infectious disease with rapid disease progression and a high mortality rate. We report a case of a 61-year-old female with type 2 diabetes who developed FG caused by Actinomyces europaeus. A. europaeus is associated with abscesses, decubitus ulcers, and purulent urethritis. Although A. europaeus rarely causes FG as the main causative pathogen, we should still be alert to this pathogenic microorganism. To our knowledge, this is the first case report of FG caused by A. europaeus mono-infection, and it adds to the evidence that A. europaeus has the potential to cause necrotizing fasciitis.
PubMed: 36821033
DOI: 10.1007/s40121-023-00781-6 -
Access Microbiology 2022Cerebral venous sinus thrombosis in children is a rare complication of acute mastoiditis that can potentially be fatal. Clinical expertise is essential for early...
Cerebral venous sinus thrombosis in children is a rare complication of acute mastoiditis that can potentially be fatal. Clinical expertise is essential for early diagnosis and management due to its subtle course. We present the first known case of paediatric acute mastoiditis with venous sinus thrombosis caused by and . A 17-year-old male presented clinical signs of right acute otitis media and mastoiditis. Brain computed tomography showed mastoid opacification, cerebral sinus thrombosis and an extradural collection. Microbiology revealed the presence of and . A multidisciplinary approach combining medical and surgical treatment allowed the patient to make a full recovery.
PubMed: 36644735
DOI: 10.1099/acmi.0.000436 -
Revista Argentina de Microbiologia 2023A brain abscess is a focal infection characterized by a collection of pus in the brain parenchyma. It is a life-threatening condition that should be diagnosed and...
A brain abscess is a focal infection characterized by a collection of pus in the brain parenchyma. It is a life-threatening condition that should be diagnosed and treated as soon as possible. We report here three cases of patients with otogenic brain abscesses of polymicrobial origin that had in common the isolation of Actinomyces europaeus, which has not been previously described in this location. A. europaeus was identified by the conventional methodology, matrix-associated laser deionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. Antibiotic susceptibility was evaluated by the epsilometric method, and all isolates showed sensitivity to penicillin, vancomycin and linezolid, whereas susceptibility to clindamycin and erythromycin was variable. MALDI-TOF MS identification allowed a quick and reliable species level identification in order to provide a rapid and effective response to avoid treatment delay that could lead to increased morbidity and even mortality.
Topics: Humans; RNA, Ribosomal, 16S; Actinomyces; Brain Abscess; Clindamycin; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
PubMed: 36642684
DOI: 10.1016/j.ram.2022.07.003 -
Journal of Surgical Case Reports Dec 2021Actinomyces europaeus is a sub-species of actinomyces first isolated in humans in 1997. It is commensal bacteria found within the genitourinary and gastrointestinal...
Actinomyces europaeus is a sub-species of actinomyces first isolated in humans in 1997. It is commensal bacteria found within the genitourinary and gastrointestinal tract. Although it is known to cause soft tissue infection and has been known to cause abscesses, it has never been identified as the primary pathogen in a case of necrotizing fasciitis. We present the case of a 59-year-old man with recurrent groin infections, poorly controlled Type 2 diabetes and obesity who developed necrotizing fasciitis of his lower abdominal wall secondary to Actinomyces europaeus. We discuss the clinical course and the value of early identification of the pathogen and specialist microbiologist advice.
PubMed: 34925755
DOI: 10.1093/jscr/rjab533 -
Journal of Surgical Case Reports Oct 2019and are two facultative anaerobes that are common contaminants of human flora; namely the urinary tract, the female genital tract and the gastrointestinal tract. has...
and are two facultative anaerobes that are common contaminants of human flora; namely the urinary tract, the female genital tract and the gastrointestinal tract. has been linked with abscesses, decubitus ulcers and purulent urethritis, while has been associated with urinary tract infections, bacteremia and Fournier's gangrene. Here we present a case report of an 84-year-old female patient found to have a necrotizing soft tissue infection caused by and To our knowledge, this is the first case report that documents as a causal agent of a necrotizing infection.
PubMed: 31636892
DOI: 10.1093/jscr/rjz286 -
Surgical Neurology International 2019Recurrent intracranial abscesses secondary to refractory otitis media present a challenge which demands multidisciplinary collaboration.
BACKGROUND
Recurrent intracranial abscesses secondary to refractory otitis media present a challenge which demands multidisciplinary collaboration.
CASE DESCRIPTION
We present the first known case of pediatric brain abscess caused by a polymicrobial infection of , , and mixed anaerobic species resulting from acute-on-chronic suppurative left otitis media. This patient required two separate stereotactic abscess drainages and a complex course of antibiotics for successful management.
CONCLUSION
Surgery is essential in the management of cerebral abscess both in agent identification and therapeutic drainage. Management of abscesses secondary to unusual and polymicrobial organisms often requires consultation from other medical and surgical specialties.
PubMed: 31528373
DOI: 10.4103/sni.sni_376_17 -
Case Reports in Infectious Diseases 2018This is a case of in the breast abscess of a penicillin-allergic woman. The mainstay of treatment for actinomycosis is penicillin, and there is a lack of literature...
This is a case of in the breast abscess of a penicillin-allergic woman. The mainstay of treatment for actinomycosis is penicillin, and there is a lack of literature describing nonpenicillin treatment options. A 69-year-old woman presented acutely with a breast abscess which was managed with incision and drainage and antibiotic therapy to good response. 21 days after presentation, were grown from the culture of pus, so the patient was recalled and more rigorous treatment and follow-up were initiated. The penicillin allergy led to difficulty in the identification of an appropriate antimicrobial agent that was also logistically feasible to be given on an outpatient IV basis. IV tigecycline followed by oral clarithromycin was found to be effective treatment.
PubMed: 30026992
DOI: 10.1155/2018/6708614 -
Journal of Infection and Public Health 2018Actinomyces species are part of the commensal flora of the mucous membranes of the oropharynx, gastrointestinal tract and female genital tract. Actinomyces europaeus is...
Actinomyces species are part of the commensal flora of the mucous membranes of the oropharynx, gastrointestinal tract and female genital tract. Actinomyces europaeus is a short, nonmotile, facultative anaerobic rod first described in 1997, susceptible in vitro to a wide range of b-lactam antibiotics which are regarded as first choice. In this report we described the case of A. europaeus infection in a young female patient admitted to Intensive Care Unit and the possible damage of vascular endothelium due to a chronic progressive actinomycosis that at first involved neck soft tissue, then cervical lymphnodes, and finally extended to the vascular structure.
Topics: Actinomyces; Actinomycosis; Anti-Bacterial Agents; Brain; Endothelium, Vascular; Female; Humans; Intensive Care Units; Lymph Nodes; Lymphadenopathy; Nervous System Diseases; RNA, Ribosomal, 16S; Symbiosis; Tomography, X-Ray Computed; Treatment Outcome; Vasculitis; Young Adult
PubMed: 29277334
DOI: 10.1016/j.jiph.2017.12.010