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BMC Infectious Diseases May 2020Brain abscesses are the rare and most severe form of actinomycosis, which usually manifests as abscesses of the occipital or parietal lobe due to direct expansion from...
BACKGROUND
Brain abscesses are the rare and most severe form of actinomycosis, which usually manifests as abscesses of the occipital or parietal lobe due to direct expansion from an adjacent area, the oral cavity. In the medical literature, there are only a few reported cases of brain abscess caused by Actinomyces meyeri. In this report, we present a 35-year-old male patient who experienced an insidious headache and left-sided weakness and was diagnosed with an Actinomyces meyeri brain abscess.
CASE PRESENTATION
A 35-year-old Nepalese man came to our institute with the primary complaint of insidious onset of headache and left-sided weakness. His physical examination was remarkable for the left-sided weakness with power 2/5 on both upper and lower limbs, hypertonia, hyperreflexia and positive Babinski sign, with intact sensory function. Cardiac examination revealed systolic murmur with regular S1 and S2, and lung examination was normal. The patient had poor dental hygiene. Biochemistry and haematology panel were normal. Urinalysis, chest X-ray and electrocardiogram revealed no abnormality. A transthoracic echocardiogram revealed mitral regurgitation. However, there was no evidence of valvular vegetation. A magnetic resonance imaging (MRI) of the brain was performed, which showed a bi-lobed rim enhancing lesion with a conglomeration of two adjoining round lesions in the right parietal parasagittal region. Perilesional oedema resulting in mass effect over the right lateral ventricle and mid-right uncal herniation with midline shift was noted. Craniotomy was performed, and the lesion was excised. Gram staining of the extracted sample revealed gram variable filamentous rods. Creamy white, moist, confluent colonies were observed after performing anaerobic culture in chocolate agar. On the gram staining, they showed gram-positive filamentous rods. Actinomyces meyeri was identified based on matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) technology. Based on the susceptibilities, he was successfully treated with ampicillin-sulbactam.
CONCLUSIONS
In conclusion, Actinomyces should be considered in the differential diagnosis of brain abscess in patients with poor dental hygiene, and early diagnosis and appropriate treatment can lead to better results.
Topics: Actinomyces; Actinomycosis; Adult; Brain Abscess; Headache; Humans; Magnetic Resonance Imaging; Male; Radiography
PubMed: 32460724
DOI: 10.1186/s12879-020-05100-9 -
BMC Oral Health May 2021Subgingival microbiome in disease-associated subgingival sites is known to be dysbiotic and significantly altered. In patients with rheumatoid arthritis (RA), the extent...
BACKGROUND
Subgingival microbiome in disease-associated subgingival sites is known to be dysbiotic and significantly altered. In patients with rheumatoid arthritis (RA), the extent of dysbiosis in disease- and health-associated subgingival sites is not clear.
METHODS
8 RA and 10 non-RA subjects were recruited for this pilot study. All subjects received full oral examination and underwent collection of subgingival plaque samples from both shallow (periodontal health-associated, probing depth ≤ 3mm) and deep subgingival sites (periodontal disease-associated, probing depth ≥ 4 mm). RA subjects also had rheumatological evaluation. Plaque community profiles were analyzed using 16 S rRNA sequencing.
RESULTS
The phylogenetic diversity of microbial communities in both RA and non-RA controls was significantly higher in deep subgingival sites compared to shallow sites (p = 0.022), and the overall subgingival microbiome clustered primarily according to probing depth (i.e. shallow versus deep sites), and not separated by RA status. While a large number of differentially abundant taxa and gene functions was observed between deep and shallow sites as expected in non-RA controls, we found very few differentially abundant taxa and gene functions between deep and shallow sites in RA subjects. In addition, compared to non-RA controls, the UniFrac distances between deep and shallow sites in RA subjects were smaller, suggesting increased similarity between deep and shallow subgingival microbiome in RA. Streptococcus parasanguinis and Actinomyces meyeri were overabundant in RA subjects, while Gemella morbillorum, Kingella denitrificans, Prevotella melaninogenica and Leptotrichia spp. were more abundant in non-RA subjects.
CONCLUSIONS
The aggregate subgingival microbiome was not significantly different between individuals with and without rheumatoid arthritis. Although the differences in the overall subgingival microbiome was driven primarily by probing depth, in contrast to the substantial microbiome differences typically seen between deep and shallow sites in non-RA patients, the microbiome of deep and shallow sites in RA patients were more similar to each other. These results suggest that factors associated with RA may modulate the ecology of subgingival microbiome and its relationship to periodontal disease, the basis of which remains unknown but warrants further investigation.
Topics: Actinomycetaceae; Arthritis, Rheumatoid; Gemella; Humans; Kingella; Microbiota; Phylogeny; Pilot Projects; Streptococcus
PubMed: 33964928
DOI: 10.1186/s12903-021-01597-x -
Life (Basel, Switzerland) Jun 2023Actinomycosis by is rare and scarcely reported in the literature. The lung is the main organ involved. Penicillin and amoxicillin are the first-choice treatments....
BACKGROUND
Actinomycosis by is rare and scarcely reported in the literature. The lung is the main organ involved. Penicillin and amoxicillin are the first-choice treatments. Surgery is indicated when empyema and abscesses are resistant to medical treatment.
CASE PRESENTATION
We report an underdiagnosed case of pleural empyema due to in a patient with closed chest trauma. The patient, a male, 47 years old, presented with a dry cough, thoracic pain, and dyspnea a month after the trauma. A chest X-ray showed a left lower lobe pleural effusion, so he was subjected to a thoracentesis, leading to a partial re-expansion of the left lung. The patient also complained about gum discomfort; thus, a dental x-ray scan was taken, which showed the presence of vertical bone resorption in a periodontal pocket. The patient was treated with levofloxacin 500 mg orally once a day, which was continued for 15 days after discharge. Two months after the accident, he presented again with intermittent fever, a worsening cough, and dyspnea. A CT scan showed thickening of the left pleura and a loculated pleural effusion with partial collapse of the left lower lobe. A decision was made to refer the patient to the Thoracic Unit to undergo surgery via a left thoracoscopic uniportal approach. The lung was thoroughly decorticated, and the purulent fluid was aspirated. The postoperative course was uneventful. Cultures showed the growth of which is sensitive to imipenem and amoxicillin. The patient started a proper antibiotic regimen and, whenever possible, was discharged. At 12 months follow-up, a chest X-ray showed a complete resolution of the left pleural effusion with complete re-expansion of the left lung.
CONCLUSIONS
Although rare, Actinomycetes infections must be considered especially in front of non-solving empyema or severe pneumonia of unknown cause because in the majority of cases, with the proper treatment, the restitutio ad integrum is possible.
PubMed: 37511825
DOI: 10.3390/life13071450 -
BMJ Case Reports Apr 2015We describe the rare occurrence of an Actinomyces meyeri cerebral abscess in a 55-year-old woman following a dental extraction. This patient presented with a 2-day...
We describe the rare occurrence of an Actinomyces meyeri cerebral abscess in a 55-year-old woman following a dental extraction. This patient presented with a 2-day history of hemisensory loss, hyper-reflexia and retro-orbital headache, 7 days following a dental extraction for apical peridonitis. Neuroimaging showed a large left parietal abscess with surrounding empyema. The patient underwent craniotomy and drainage of the abscess. A. meyeri was cultured. Actinomycosis is a rare cause of cerebral abscess. The A. meyeri subtype is particularly rare, accounting for less than 1% of specimens. This case describes an unusually brief course of the disease, which is usually insidious. Parietal lobe involvement is unusual as cerebral abscesses usually have a predilection for the frontal and temporal regions of the brain. Although there are no randomised trials to guide therapy, current consensus is to use a prolonged course of intravenous antibiotics, followed by 6-12 months of oral therapy.
Topics: Actinomyces; Actinomycosis; Anti-Bacterial Agents; Brain Abscess; Diagnosis, Differential; Female; Gait Disorders, Neurologic; Headache; Humans; Middle Aged; Radiography; Tooth Extraction; Treatment Outcome
PubMed: 25870213
DOI: 10.1136/bcr-2014-207548 -
Internal Medicine (Tokyo, Japan) 2014We herein present a rare case of Actinomyces meyeri-induced meningitis that occurred in a patient of advanced age with poor oral hygiene. Although Gram staining of the... (Review)
Review
We herein present a rare case of Actinomyces meyeri-induced meningitis that occurred in a patient of advanced age with poor oral hygiene. Although Gram staining of the cerebrospinal fluid (CSF) revealed Gram-positive rods and a blood culture was positive for the organism, a bacterial culture of the CSF was negative. Anaerobic cultures of CSF specimens are not routinely performed; however, anaerobes are sometimes involved in central nervous system infection. We therefore believe that anaerobic cultures should be considered in high-risk cases, such as those involving necrotizing bowel lesions or poor oral hygiene. A negative result on a CSF culture can result in misdiagnosis and inappropriate treatment.
Topics: Actinomyces; Aged, 80 and over; Bacteria, Anaerobic; Female; Humans; Meningitis, Bacterial
PubMed: 24390532
DOI: 10.2169/internalmedicine.53.0403 -
BMJ Case Reports Feb 2022We describe the presentation of a 72-year-old woman with concurrent diagnoses of lung adenocarcinoma in conjunction with disseminated A infection; a rare pathogen which...
We describe the presentation of a 72-year-old woman with concurrent diagnoses of lung adenocarcinoma in conjunction with disseminated A infection; a rare pathogen which can mimic lung cancer both symptomatically and radiologically. The patient was found to have a pelvic mass initially presumed to be cervical metastases-later confirmed to be of xanthogranulomatous inflammatory origin following transvaginal ultrasound-guided biopsy. The pathogenic cause, identified following pleural aspirate, being a fully sensitive infection; treated with prolonged course amoxicillin.
Topics: Actinomyces; Actinomycetaceae; Actinomycosis; Aged; Carcinoma, Bronchogenic; Female; Humans; Lung Neoplasms
PubMed: 35135804
DOI: 10.1136/bcr-2021-247577 -
Respiratory Medicine Case Reports 2017is a rare pathogen and an infrequent cause of human actinomycosis. Less than ten cases were reported in the English-literature to date concerning empyema. We herein...
is a rare pathogen and an infrequent cause of human actinomycosis. Less than ten cases were reported in the English-literature to date concerning empyema. We herein report a case to promote the awareness and adequate management of the disease. A 44-year-old immunocompetent male with known pulmonary disease was diagnosed with an empyema. He underwent chest tube drainage and a short-term treatment with clindamycin for 4 months. This is the first report of a patient with structural pulmonary disease with an empyema treated with 4-month of clindamycin and chest tube drainage. In comparison to previous reports, our case was diagnosed early, empyema was effectively drained with one chest tube and symptoms and radiological findings were rapidly improved. Short-term antibiotic treatment can be well succeeded if an early diagnosis is made, there is no evidence of dissemination and adequate management is promptly instituted.
PubMed: 28879077
DOI: 10.1016/j.rmcr.2017.08.010 -
Case Reports in Obstetrics and... 2018bacterium resides on mucosal surfaces and is uncommonly pathogenic. When does cause infection, these infections are typically pulmonary in origin and have the capacity...
bacterium resides on mucosal surfaces and is uncommonly pathogenic. When does cause infection, these infections are typically pulmonary in origin and have the capacity to disseminate throughout the body. is an uncommon cause of pelvic infection. We present a unique case of a posthysterectomy abscess caused by this particular bacterium.
PubMed: 30034893
DOI: 10.1155/2018/3842048 -
EBioMedicine Dec 2021Little is known about chronic cannabis smoking-associated oral microbiome and its effects on central nervous system (CNS) functions.
BACKGROUND
Little is known about chronic cannabis smoking-associated oral microbiome and its effects on central nervous system (CNS) functions.
METHODS
In the current study, we have analyzed the saliva microbiome in individuals who chronically smoked cannabis with cannabis use disorder (n = 16) and in non-smoking controls (n = 27). The saliva microbiome was analyzed using microbial 16S rRNA sequencing. To investigate the function of cannabis use-associated oral microbiome, mice were orally inoculated with live Actinomyces meyeri, Actinomyces odontolyticus, or Neisseria elongata twice per week for six months, which mimicked human conditions.
FINDINGS
We found that cannabis smoking in humans was associated with oral microbial dysbiosis. The most increased oral bacteria were Streptococcus and Actinomyces genus and the most decreased bacteria were Neisseria genus in chronic cannabis smokers compared to those in non-smokers. Among the distinct species bacteria in cannabis smokers, the enrichment of Actinomyces meyeri was inversely associated with the age of first cannabis smoking. Strikingly, oral exposure of Actinomyces meyeri, an oral pathobiont, but not the other two control bacteria, decreased global activity, increased macrophage infiltration, and increased β-amyloid 42 protein production in the mouse brains.
INTERPRETATION
This is the first study to reveal that long-term oral cannabis exposure is associated oral enrichment of Actinomyces meyeri and its contributions to CNS abnormalities.
Topics: Amyloid beta-Peptides; Animals; Bacteria; Brain; Case-Control Studies; Cell Line; DNA, Bacterial; DNA, Ribosomal; Disease Models, Animal; Female; Humans; Macrophages; Marijuana Smoking; Mice; Phylogeny; RNA, Ribosomal, 16S; Saliva; Sequence Analysis, DNA
PubMed: 34826801
DOI: 10.1016/j.ebiom.2021.103701 -
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