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Cureus Jul 2023Breast abscesses can be a complication of infectious mastitis or the first presentation of a breast infection, presenting as pain, erythema, and a lump. Actinomycosis is...
Breast abscesses can be a complication of infectious mastitis or the first presentation of a breast infection, presenting as pain, erythema, and a lump. Actinomycosis is a rare chronic disease caused by anaerobic branched filamentous gram-positive bacteria belonging to the genus. It is usually found in the human mouth, digestive tract, and genital tract but can also cause breast abscesses. Actinomycosis affecting the breast is a rare condition that typically occurs as a secondary infection resulting from a pulmonary infection. It is primary when inoculation occurs through the nipple. This report describes the case of a 48-year-old institutionalized female with periareolar swelling in the right breast that had been evolving for approximately two months. The abscess was drained, and the aspirated material contained , a gram-positive bacterium. Actinomycosis of the breast can manifest as either a sinus tract or mass-like features that closely resemble malignancy. The clinical presentation can pose challenges in distinguishing between primary actinomycosis, mastitis, and inflammatory carcinoma. Treatment consists of drainage with needle aspiration or surgical drainage and antibiotic therapy.
PubMed: 37602065
DOI: 10.7759/cureus.42092 -
Frontiers in Microbiology 2023, previously known as , is increasingly recognized as a causative agent of various human infections, while its taxonomy and genomic insights are still understudied.
Comparative genomic analyses of the clinically-derived strain NY0527: the reassignment of subsp. and subsp. into two separate species and insights into their virulence characteristics.
BACKGROUND
, previously known as , is increasingly recognized as a causative agent of various human infections, while its taxonomy and genomic insights are still understudied.
METHODS
A strain NY0527 was isolated from the hip abscess of a patient, and its antibiotic susceptibility was assessed. The genome was hybrid assembled from long-reads and short-reads sequencing. Whole-genome-based analyses on taxa assignment, strain diversity, and pathogenesis were conducted.
RESULTS
The strain was found to be highly susceptible to beta-lactam antibiotics, but resistant to erythromycin, clindamycin, and amikacin. The complete genome sequences of this strain were assembled and found to consist of a circular chromosome and a circular plasmid. Sequence alignment to the NCBI-nt database revealed that the plasmid had high sequence identity (>90%) to four plasmids, with 40-50% query sequence coverage. Furthermore, the plasmid was discovered to possibly originate from the sequence recombination events of two plasmid families. Phylogenomic tree and genomic average nucleotide identity analyses indicated that many sp. strains were still erroneously assigned as sp. strains, and the documented subspecies within should be reclassified as two separate species (i.e., and ). The core genome of each species carried a chromosome-coded beta-lactamase expression repressor gene, which may account for their broadly observed susceptibility to beta-lactam antibiotics in clinical settings. Additionally, an gene that expresses fluoroquinolone resistance was shared by some and strains, possibly acquired by IS6 transposase-directed gene transfer events. In contrast, tetracycline resistance genes were exclusively carried by strains. In particular, was found to be more pathogenic than by encoding more virulence factors (i.e., 35-38 in vs 27-31 in ). Moreover, both species encoded two core pathogenic virulence factors, namely hemolysin and sialidase, which may facilitate their infections by expressing poreformation, adhesion, and immunoglobulin deglycosylation activities.
CONCLUSION
This study highlights the underappreciated taxonomic diversity of spp. and provides populational genomic insights into their antibiotic susceptibility and pathogenesis for the first time, which could be helpful in the clinical diagnosis and treatment of spp. infections.
PubMed: 37152761
DOI: 10.3389/fmicb.2023.1147469 -
Frontiers in Microbiology 2022Vaginal and cervical canal bacteria are associated with women's health and pregnancy outcomes. Here, we compared their composition and characteristics in 37...
Vaginal and cervical canal bacteria are associated with women's health and pregnancy outcomes. Here, we compared their composition and characteristics in 37 reproductive-aged Chinese women including 24 pregnant women with cervical incompetence (vaginal and cervical canal bacteria formed Groups A and B, respectively) and 13 healthy pregnant women (vaginal and cervical canal bacteria formed Groups C and D, respectively) using high-throughput sequencing of the V4 region of 16S rRNA gene. The results of alpha and beta diversity analysis, respectively, indicated no statistical differences between Groups A and B ( = 0.32, 0.06), nor Groups B and D ( = 0.69, 0.74); however, differences were found between Groups C and D ( = 0.02, 0.01) and between Groups A and C ( = 0.04, 0.02). PLS-DA analysis showed that the individuals from each group were irregularly distributed according to their clade. , and were the dominant genera in all groups. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSts) analysis identified 31 Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologs associated with the bacterial communities from the four groups, including membrane transport, folding, sorting and degradation, xenobiotics biodegradation and metabolism, and nucleotide metabolism. We further determined relationships between pregnancy outcomes (Apgar scores) and certain bacterial species. A significant positive correlation was found between Apgar scores and and in the vagina and cervical canal of pregnant women with cervical incompetence while , and in the cervical canal displayed negative correlations with Apgar scores. Moreover, , , and in the vagina were negatively correlated with Apgar scores. These bacteria may serve as potential biomarkers, however, additional research is warranted to verify their role in clinical outcomes.
PubMed: 36246259
DOI: 10.3389/fmicb.2022.986326 -
European Heart Journal. Case Reports Aug 2022Actinomycosis is a chronic invasive infection caused by species. Actinomycosis endocarditis has been described, yet considered rare. We present the first reported...
BACKGROUND
Actinomycosis is a chronic invasive infection caused by species. Actinomycosis endocarditis has been described, yet considered rare. We present the first reported transcatheter aortic valve implantation (TAVI)-related actinomycosis endocarditis.
CASE SUMMARY
A 70-year-old female patient, presented 4 months after TAVI with malaise and vocal-cord paralysis. She underwent computed tomography angiography which demonstrated a 28 mm pseudoaneurysm of the ascending aorta, which compressed the laryngeal nerves. Her condition rapidly deteriorated with cardiogenic shock and required an emergent surgery, which reviled a tamponade with active bleeding, due to an ascending aortic dissection. She underwent aortic valve and ascending aorta replacement. A 2 cm vegetation was found on the TAVI prosthetic valve and sent for cultures, which later revealed an infection. Long-term intravenous ampicillin treatment was given.
DISCUSSION
This case describes a patient with endocarditis on TAVI prosthetic valve, with an unusual clinical presentation and rapid deterioration to an emergency intervention. This unique presentation of tumour-like tissue invasion is characteristic of actinomycosis, and should be suspected especially following valve replacement.
PubMed: 36043211
DOI: 10.1093/ehjcr/ytac302 -
BMC Veterinary Research Feb 2022Canine aortic valve endocarditis carries a poor prognosis. In the current literature there are only two reports of infectious endocarditis associated with Actinomyces;...
BACKGROUND
Canine aortic valve endocarditis carries a poor prognosis. In the current literature there are only two reports of infectious endocarditis associated with Actinomyces; Actinomyces turicensis and an Actinomyces-like organism. Endocarditis due to Actinomyces neuii subsp. anitratus (now known as Winkia neuii subsp. anitrata) has rarely been reported in humans, and to the best of our knowledge, has never been reported in dogs.
CASE PRESENTATION
A 4 year-3 months old female neutered Great Dane presented with lethargy, hyporexia, 'praying position' stance, acute onset of cherry eye and pyrexia. A subtle diastolic heart murmur was detected on thoracic auscultation and echocardiology revealed an irregular lesion adhered to the ventricular aspect of the aortic valve, suggestive of aortic valve endocarditis. Peripheral blood was collected for blood culture. Following 10 days of incubation, blood cultures yielded a growth of aerobic gram-positive filamentous rods which were further biochemically (BioMerieux API Coryne profiling strip) identified as Actinomyces neuii subsp. anitratus. The patient was treated with marbofloxacin and amoxicillin/clavulanic acid for five consecutive months. On repeat echogram, following treatment completion, there was no evidence of aortic valve endocarditis. To the best of our knowledge this is the first case report documenting successful treatment of aortic valve endocarditis caused by Actinomyces neuii subsp. anitratus in a dog.
CONCLUSIONS
Despite the poor prognosis of canine infectious aortic valve endocarditis, patients with Actinomyces neuii subsp. anitratus infection might have a favourable outcome. It is therefore important identifying the underling infectious cause, as it may have a significant impact on prognosis and treatment outcome when it is caused by Actinomyces neuii subsp. anitratus.
Topics: Actinomyces; Actinomycosis; Animals; Aorta; Dog Diseases; Dogs; Endocarditis; Endocarditis, Bacterial; Female; Humans
PubMed: 35114997
DOI: 10.1186/s12917-022-03161-3 -
Journal of Ophthalmic Inflammation and... Jan 2021The role of systemic antibiotics in the treatment of bacterial endophthalmitis remains controversial. While penicillin is a highly effective antibiotic against bacteria...
IMPORTANCE
The role of systemic antibiotics in the treatment of bacterial endophthalmitis remains controversial. While penicillin is a highly effective antibiotic against bacteria that frequently cause endophthalmitis, the ability of systemically administered Penicillin G to penetrate into the vitreous at adequate therapeutic concentrations has not been studied. Its role in the treatment of endophthalmitis, particularly for bacteria for which it is the antibiotic of choice, therefore remains unknown.
OBJECTIVE
We sought to determine whether intravenous administration of Penicillin G leads to adequate therapeutic concentrations in the vitreous for the treatment of bacterial endophthalmitis.
DESIGN AND SETTING
This study was conducted in an ambulatory setting, at the Ottawa Hospital Eye Institute, a university-affiliated tertiary care center, where a 77-year old gentleman with chronic post-cataract surgery Actinomyces neuii endophathalmitis was treated with intravenous Penicillin G (4 × 10 units every 4 h) and intravitreal ampicillin (5000μg/0.1 m1).
MAIN OUTCOMES AND MEASURES
Intravitreal concentration of Penicillin G and ampicillin were obtained at the time of intraocular lens removal, measured by high-performance liquid chromatography.
RESULTS
The intravitreal concentration of penicillin and ampicillin was 3.5μg/ml and 0.3μg/ml, respectively. Both the concentration of penicillin and ampicillin were within the level of detection of their respective assays (penicillin 0.06-5μg/ml, ampicillin 0.12-2.5μg/ml).
CONCLUSION AND RELEVANCE
This study shows that intravenous Penicillin G administered every four-hours allows for adequate intravitreal concentrations of penicillin. Future studies are required to determine if the results of this study translate into improved clinical outcomes.
PubMed: 33479857
DOI: 10.1186/s12348-020-00232-0 -
BMJ Case Reports Sep 2020A 72-year-old man with a history of right reverse shoulder arthroplasty presented with a 1-month history of erythema, pain and drainage from the right shoulder....
A 72-year-old man with a history of right reverse shoulder arthroplasty presented with a 1-month history of erythema, pain and drainage from the right shoulder. Arthrocentesis was performed and synovial fluid gram stain revealed gram-positive rods. Clinical diagnosis of prosthetic shoulder joint infection was made. Orthopaedic surgeons performed irrigation and debridement with resection of the right shoulder prothesis and implantation of an antimicrobial spacer. Operative cultures grew The patient was treated with 6 weeks of ceftriaxone with improvement in both clinical symptoms and laboratory values. species remain a rare cause of late prosthetic joint infection (PJI) due to their slow growing and indolent course. While generalised actinomycosis is often treated with 6-12 months of antibiotics, the treatment course of PJI is not well characterised, with some sources suggesting a minimum of 6 weeks of antimicrobial therapy.
Topics: Actinomyces; Actinomycosis; Aged; Anti-Bacterial Agents; Ceftriaxone; Humans; Male; Prosthesis-Related Infections; Shoulder Joint; Shoulder Prosthesis
PubMed: 32994271
DOI: 10.1136/bcr-2020-236350 -
Microbiology Resource Announcements Jun 2020is an opportunistic pathogen. Within the urogenital tract, it has been associated with bacterial vaginosis and overactive bladder symptoms. Here, we investigate a draft...
is an opportunistic pathogen. Within the urogenital tract, it has been associated with bacterial vaginosis and overactive bladder symptoms. Here, we investigate a draft genome sequence of UMB1295, which was isolated from a catheterized urine sample from a woman with a urinary tract infection.
PubMed: 32499345
DOI: 10.1128/MRA.00402-20 -
International Journal of Infectious... Sep 2019Actinomyces infection is a tissue destructive, low-grade infection that often resembles malignancy. We report the case of a 70-year-old male with repeated,...
Actinomyces infection is a tissue destructive, low-grade infection that often resembles malignancy. We report the case of a 70-year-old male with repeated, culture-negative urinary tract infections while intermittently catheterized. At presentation, the patient reported a new episode of urinary tract infection with white discharge in his urine. Transrectal ultrasonography showed two lesions in the prostate, suspect for prostate cancer. However, biopsy did not show cancer, and anaerobic culture grew Actinomyces neuii. A 3-month antibiotic course of amoxicillin eventually cured the infection. This is a case of prostatic soft tissue infection with A. neuii. It is important to consider Actinomyces infection in patients with a non-malignant prostatic mass. Although β-lactam antibiotics do not penetrate the prostate well, the Actinomyces infection was cured by prolonged amoxicillin treatment in this case. It is possible that the tissue damage enhanced the amoxicillin concentration in the infected prostate.
Topics: Actinomyces; Actinomycosis; Aged; Amoxicillin; Anti-Bacterial Agents; Diagnosis, Differential; Humans; Male; Prostate; Prostatic Diseases; Prostatic Neoplasms; Recurrence; Ultrasonography; Urinary Tract Infections
PubMed: 31288092
DOI: 10.1016/j.ijid.2019.06.029 -
BMC Infectious Diseases Jun 2019Infective endocarditis caused by Actinomyces spp. is extremely rare. However, cases by new species of Actinomyces have been increasingly reported due to advances in...
BACKGROUND
Infective endocarditis caused by Actinomyces spp. is extremely rare. However, cases by new species of Actinomyces have been increasingly reported due to advances in laboratory techniques, and many of these species do not cause classic presentations of actinomycosis. Actinomyces neuii is reported to have a tendency to cause endovascular infection. The course of infective endocarditis caused by Actinomyces spp. is usually indolent.
CASE PRESENTATION
A 61-year-old man with history of infective endocarditis, end stage renal disease, and monoclonal gammopathy was admitted for an abrupt fever, confusion, dysarthria, and facial droop after hemodialysis. Echocardiogram showed vegetations on both the aortic and mitral valves. Two sets of blood culture grew A. neuii. Brain MRI showed multiple bilateral cerebral infarcts consistent with septic emboli. The patient recovered after valvular surgery and prolonged intravenous and oral antibiotic therapy.
CONCLUSIONS
This case illustrates an unusually acute presentation of A. neuii infective endocarditis. As with other Gram-positive bacilli, Actinomyces spp. isolates are often regarded as a result of contamination. One should keep it in mind as a cause of infective endocarditis in vulnerable patient populations.
Topics: Actinomyces; Actinomycosis; Acute Disease; Anti-Bacterial Agents; Echocardiography; Endocarditis; Humans; Male; Middle Aged
PubMed: 31182045
DOI: 10.1186/s12879-019-4149-2