-
Journal of Infection and Public Health Apr 2023Pulmonary actinomycosis is a rare infection caused by the bacterial species actinomyces. This paper aims to provide a comprehensive review of pulmonary actinomycosis to... (Review)
Review
Pulmonary actinomycosis is a rare infection caused by the bacterial species actinomyces. This paper aims to provide a comprehensive review of pulmonary actinomycosis to improve awareness and knowledge. The literature was analysed using databases including Pubmed, Medline and Embase from 1974 to 2021. After inclusion and exclusion, a total of 142 papers were reviewed. Pulmonary actinomycosis is a rare disease occurring in approximately 1 per 3,000,000 people annually. Historically, pulmonary actinomycosis was a common infection with high mortality; however, the infection has become rarer since the widespread use of penicillins. Actinomycosis is known as "the great masquerade"; however, it can be differentiated from other diseases with acid-fast negative ray-like bacilli and sulphur granules being pathognomonic. Complications of the infection include empyema, endocarditis, pericarditis, pericardial effusion, and sepsis. The mainstay of treatment is prolonged antibiotic therapy, with adjuvant surgery in severe cases. Future research should focus on multiple areas, including the potential risk secondary to immunosuppression from newer immunotherapies, the utility of newer diagnostic techniques and ongoing surveillance post-therapy.
Topics: Humans; Actinomycosis; Actinomyces; Lung Diseases; Anti-Bacterial Agents; Penicillins
PubMed: 36801629
DOI: 10.1016/j.jiph.2023.02.004 -
Clinical Microbiology Reviews Apr 2015Actinomyces israelii has long been recognized as a causative agent of actinomycosis. During the past 3 decades, a large number of novel Actinomyces species have been... (Review)
Review
Actinomyces israelii has long been recognized as a causative agent of actinomycosis. During the past 3 decades, a large number of novel Actinomyces species have been described. Their detection and identification in clinical microbiology laboratories and recognition as pathogens in clinical settings can be challenging. With the introduction of advanced molecular methods, knowledge about their clinical relevance is gradually increasing, and the spectrum of diseases associated with Actinomyces and Actinomyces-like organisms is widening accordingly; for example, Actinomyces meyeri, Actinomyces neuii, and Actinomyces turicensis as well as Actinotignum (formerly Actinobaculum) schaalii are emerging as important causes of specific infections at various body sites. In the present review, we have gathered this information to provide a comprehensive and microbiologically consistent overview of the significance of Actinomyces and some closely related taxa in human infections.
Topics: Actinomyces; Actinomycosis; Anti-Bacterial Agents; Bacterial Typing Techniques; Classification; Humans; Microbial Sensitivity Tests
PubMed: 25788515
DOI: 10.1128/CMR.00100-14 -
Revista Da Sociedade Brasileira de... 2022
Topics: Humans; Actinomycosis; Tomography, X-Ray Computed
PubMed: 36287474
DOI: 10.1590/0037-8682-0315-2022 -
Clinical Microbiology and Infection :... Aug 2003Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the...
Intra-abdominal and extraperitoneal actinomycosis are rare infections, caused by different Actinomyces species. However, they have been diagnosed more frequently in the last ten years. We report three cases of abdominal actinomycosis and a literature review of the last eight years. All three patients were diagnosed by means of histopathologic examination only. In one case, an intrauterine device (IUD) was associated with the infection. Therapy consisted of surgical resection of the inflammatory, infected tissue, and long-term antibiotic therapy. All patients are free of recurrence. Abdominal actinomycosis should be included in the differential diagnosis of an abdominal pathology of insidious onset, especially when an IUD is in place. Even when infection had spread extensively, combined operative and antibiotic therapy cured most of the cases.
Topics: Abdominal Abscess; Actinomycosis; Adult; Aged; Diagnosis, Differential; Female; Humans; Intrauterine Devices; Male; Middle Aged
PubMed: 14616714
DOI: 10.1046/j.1469-0691.2003.00653.x -
QJM : Monthly Journal of the... Nov 2021
Topics: Actinomycosis; Diagnosis, Differential; Humans
PubMed: 33682880
DOI: 10.1093/qjmed/hcab048 -
Revista Da Associacao Medica Brasileira... Mar 2022Pulmonary actinomycosis, clinically and radiologically, mimics abscess, tuberculosis, and lung malignancy, resulting in misdiagnosis or delay in diagnosis. In this...
INTRODUCTION
Pulmonary actinomycosis, clinically and radiologically, mimics abscess, tuberculosis, and lung malignancy, resulting in misdiagnosis or delay in diagnosis. In this study, we analyzed the clinicoradiological features of pulmonary actinomycosis, the presence of any differences between clinical prediagnosis and radiological diagnosis, and whether imaging modalities help distinguish pulmonary actinomycosis from lung cancer.
METHODS
A total of 22 patients who had a histopathological diagnosis of actinomycosis in a tertiary health center participated in this study. Of these, 14 had positron-emission tomography/computed tomography.
RESULTS
In all, 81.8% of the patients were males. The diagnostic procedures employed for the diagnosis of actinomycosis were surgery in 54.5% of patients, fiberoptic bronchoscopy in 36.4% of patients, and rigid bronchoscopy in 9.1% of patients. Radiological and clinical prediagnosis showed malignancy in 31.8 and 40.9% of patients, respectively. The mean of the maximum standardized uptake value was 6.33±3.6 on positron-emission tomography/computed tomography. Kappa compliance analysis revealed that clinical and radiological diagnoses were significantly compatible with each other and that radiological pre-diagnoses were not superior to clinical diagnoses (κ=0.701 and p<0.001).
CONCLUSION
Pulmonary actinomycosis shows high metabolic uptake in positron-emission tomography/computed tomography, and this may mislead clinicians for a diagnosis of malignancy. Our results suggest that positron-emission tomography/computed tomography does not help distinguish pulmonary actinomycosis from lung malignancy and does not provide a clear diagnostic benefit to the clinician, so pathological diagnosis is necessary.
Topics: Actinomycosis; Bronchoscopy; Diagnosis, Differential; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Radiography
PubMed: 35442366
DOI: 10.1590/1806-9282.20211017 -
International Journal of Surgery... Dec 2007Abdominal actinomycosis has been recognised for over 150 years yet remains largely unknown to most clinicians. It's varied presentations are usually considered to... (Review)
Review
Abdominal actinomycosis has been recognised for over 150 years yet remains largely unknown to most clinicians. It's varied presentations are usually considered to represent malignancy rather than an infective process - and was once described as 'the most misdiagnosed disease'. Actinomyces are gram positive bacilli of the Actinomycetales genus, and A. israelii is responsible for the majority of human disease. They are normal commensal inhabitants of the human bronchial and gastrointestinal tracts and seem to only cause pathological infection after preceding mucosal breakdown. Patients who have undergone appendicectomy, have had a missed perforated appendicitis or women with a history of intrauterine contraceptive device use are at an increased risk. Florid abscess formation with fistulation, abundant granulation and dense surrounding fibrosis are common. Diagnosis prior to, or even during, surgery is rare and the findings are usually mistaken for acute inflammatory pathologies or malignancy. The treatment of choice is prolonged antibiotic therapy, usually with penicillin to which the organisms remain exquisitely sensitive, although delayed recurrence is possible. This review outlines the historical background of actinomyceal infection and considers the epidemiology, pathophysiology and clinical features of abdominal actinomycosis.
Topics: Abdomen; Actinomycosis; Humans
PubMed: 18078685
DOI: 10.1016/j.ijsu.2006.06.009 -
BMJ Case Reports Aug 2012Actinomycosis is a rare chronic infection caused by species of Actinomyces and characterised by abscess formation, tissue fibrosis, suppurative lesions and fistulas with...
Actinomycosis is a rare chronic infection caused by species of Actinomyces and characterised by abscess formation, tissue fibrosis, suppurative lesions and fistulas with purulent discharge containing sulphur granules. Owing to its multiform manners of presentation and non-specificity from its clinical features, it has been considered as a challenging diagnosis. Periapical actinomycosis is one of the rarest forms of actinomycosis occurring in the maxillofacial region. In its occurrence it presents in the form of persistent and recurrent draining fistula in the periapical region. We report a case of periapical actinomycosis occurred in endodontically treated teeth and accidentally found to be actinomycosis during histopatological examination. An insight towards the portal of entry of the organisms into the periapical region is also discussed. The practice of sending even a tiny bit of tissues to histopathology obtained from periapical surgery will very well demonstrate this disease and help in rapid resolution through appropriate antibiotic therapy.
Topics: Actinomycosis; Adult; Amoxicillin; Anti-Bacterial Agents; Dental Fistula; Humans; Male; Periapical Diseases; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 22854234
DOI: 10.1136/bcr-2012-006218 -
The New England Journal of Medicine Sep 2018
Topics: Actinomycosis; Humans; Lung Diseases; Male; Middle Aged; Tomography, X-Ray Computed
PubMed: 30207906
DOI: 10.1056/NEJMicm1802090 -
European Review For Medical and... Nov 2022Pulmonary actinomycosis is a rare and chronic infectious disease that mimics malignancy and is frequently misdiagnosed. There are few reports that address the clinical...
OBJECTIVE
Pulmonary actinomycosis is a rare and chronic infectious disease that mimics malignancy and is frequently misdiagnosed. There are few reports that address the clinical characteristics of pulmonary actinomycosis. The objective of this research is to evaluate the clinical features, radiological findings, diagnostic approaches and treatment outcomes of pulmonary actinomycosis.
PATIENTS AND METHODS
Thirty-seven patients with pulmonary actinomycosis histopathologically diagnosed from 2009 to 2021 were analyzed retrospectively.
RESULTS
The mean age at presentation was 53.7 (±13.3) years. Frequent symptoms were cough and hemoptysis. The median diagnosis time from the first symptoms was 60 days (interquartile range 18-195). Pulmonary comorbidity was found in 59.5% of cases. The most common thorax computed tomography finding was mass or nodule. The low-attenuation center within the mass or consolidation was observed in 40% of the lesions. The median maximal standardized uptake value of lesions on positron emission tomography (PET) was 6.5 (interquartile range 2.7-10.3). In the majority of cases (97.3%), the diagnosis of pulmonary actinomycosis was not suspected at admission, and 56.8% of patients were misdiagnosed with lung cancer. The mean duration of antibiotic therapy was 9.4 days (range 3-22) with intravenous antibiotics and 64.7 days (range 5-270) with oral antibiotics. Four patients died due to concomitant comorbidities. Eight cases were lost to follow-up. All other cases were fully cured.
CONCLUSIONS
Pulmonary actinomycosis mimics other diseases, often lung cancer. Clinicians should consider the diagnosis of actinomycosis when they detect a mass or consolidation, especially with a low-attenuation center. PET/CT appears not to be useful for differential diagnosis. A shorter course of antibiotic therapy than traditionally recommended appears to be sufficient.
Topics: Humans; Adult; Middle Aged; Aged; Positron Emission Tomography Computed Tomography; Retrospective Studies; Actinomycosis; Lung Diseases; Lung Neoplasms; Treatment Outcome; Anti-Bacterial Agents
PubMed: 36394726
DOI: 10.26355/eurrev_202211_30160