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BMJ Case Reports Apr 2021A 33-year-old man without significant medical history presented to the emergency department with a 6-month history of fatigue and 30 pounds of unintentional weight loss,...
A 33-year-old man without significant medical history presented to the emergency department with a 6-month history of fatigue and 30 pounds of unintentional weight loss, with a recent cough and fever over the past week. He recalled two similar illnesses during college that did not require medical care. He denied tobacco use but reported inhaling marijuana 1-2 times daily over the past year with a vaping device. Physical exam was notable for a temperature of 100.0°F and an elevated blood pressure at 161/77 mm Hg. He was diaphoretic with clear breath sounds bilaterally. Chest imaging revealed diffuse ground glass opacities with subpleural sparing and mildly enlarged hilar lymph nodes. Bronchoscopy with transbronchial lung biopsies and needle aspirate of lymph nodes revealed organising pneumonia, and subsequent cultures grew He was treated with amoxicillin and corticosteroids with subsequent resolution on repeat chest imaging.
Topics: Actinomycosis; Adult; Cannabis; Cough; Humans; Lung Diseases; Male; Vaping
PubMed: 33795280
DOI: 10.1136/bcr-2020-240973 -
Atencion Primaria Oct 2020
Topics: Abdominal Wall; Actinomycosis; Anti-Bacterial Agents; Humans
PubMed: 32576382
DOI: 10.1016/j.aprim.2020.04.009 -
The European Respiratory Journal Mar 2003Pulmonary actinomycosis is a rare but important and challenging diagnosis to make. Even when the clinical suspicion is high, the disease is commonly confused with other... (Review)
Review
Pulmonary actinomycosis is a rare but important and challenging diagnosis to make. Even when the clinical suspicion is high, the disease is commonly confused with other chronic suppurative lung diseases and with malignancy. An early, accurate diagnosis will prevent the considerable psychological and physical morbidity, including unwarranted surgery, associated with delayed diagnosis. The clinical, radiological and therapeutic characteristics of the infection are reviewed here. Respiratory physicians should be aware of this important differential when investigating patients for persistent pulmonary shadowing. This will expedite the diagnosis of an otherwise highly treatable condition with an excellent prognosis if picked up early.
Topics: Actinomycosis; Anti-Bacterial Agents; Bronchoscopy; Drug Therapy, Combination; Female; Humans; Incidence; Lung Diseases; Magnetic Resonance Imaging; Male; Prognosis; Radiography, Thoracic; Risk Assessment; Severity of Illness Index; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 12662015
DOI: 10.1183/09031936.03.00089103 -
Orphanet Journal of Rare Diseases Jun 2023CNS actinomycosis is a rare chronic suppurative infection with non-specific clinical features. Diagnosis is difficult due to its similarity to malignancy, nocardiosis... (Review)
Review
BACKGROUND
CNS actinomycosis is a rare chronic suppurative infection with non-specific clinical features. Diagnosis is difficult due to its similarity to malignancy, nocardiosis and other granulomatous diseases. This systematic review aimed to evaluate the epidemiology, clinical characteristics, diagnostic modalities and treatment outcomes in CNS actinomycosis.
METHODS
The major electronic databases (PubMed, Google Scholar, and Scopus) were searched for the literature review by using distinct keywords: "CNS" or "intracranial" or "brain abscess" or "meningitis" OR "spinal" OR "epidural abscess" and "actinomycosis." All cases with CNS actinomycosis reported between January 1988 to March 2022 were included.
RESULTS
A total of 118 cases of CNS disease were included in the final analysis. The mean age of patients was 44 years, and a significant proportion was male (57%). Actinomycosis israelii was the most prevalent species (41.5%), followed by Actinomyces meyeri (22.6%). Disseminated disease was found in 19.5% of cases. Most commonly involved extra-CNS organs are lung (10.2%) and abdomen (5.1%). Brain abscess (55%) followed by leptomeningeal enhancement (22%) were the most common neuroimaging findings. Culture positivity was found in nearly half of the cases (53.4%). The overall case-fatality rate was 11%. Neurological sequelae were present in 22% of the patients. On multivariate analysis, patients who underwent surgery with antimicrobials had better survival (adjusted OR 0.14, 95% CI 0.04-0.28, p value 0.039) compared to those treated with antimicrobials alone.
CONCLUSION
CNS actinomycosis carries significant morbidity and mortality despite its indolent nature. Early aggressive surgery, along with prolonged antimicrobial treatment is vital to improve outcomes.
Topics: Humans; Male; Adult; Abscess; Actinomycosis; Central Nervous System Diseases; Treatment Outcome
PubMed: 37269006
DOI: 10.1186/s13023-023-02744-z -
Indian Journal of Dermatology,... 2017
Topics: Actinomycosis; Adult; Humans; Male; Mandibular Diseases; Osteomyelitis; Tooth Extraction
PubMed: 28540876
DOI: 10.4103/ijdvl.IJDVL_685_16 -
Indian Journal of Dermatology,... 2018
Topics: Actinomycosis; HIV Infections; Humans; Osteomyelitis
PubMed: 29451191
DOI: 10.4103/ijdvl.IJDVL_516_17 -
Monaldi Archives For Chest Disease =... Nov 2021Pulmonary actinomycosis is an uncommon infectious disease. Although the gold standard for diagnosis is histological examination with bacterial culture of lung tissue,...
Pulmonary actinomycosis is an uncommon infectious disease. Although the gold standard for diagnosis is histological examination with bacterial culture of lung tissue, cytology samples offer a fast and low-cost alternate diagnostic procedure. The cytology literature on this topic is limited to mostly case reports. Therefore, the aim of this study was to review cytological material in a series of patients with a diagnosis of pulmonary actinomycosis to characterize the main cytomorphological findings. Different cytological respiratory samples including sputum smears, bronchoalveolar lavages (BALs), transthoracic or endobronchial fine needle aspiration cytology (FNAC) and cell block preparations were used for retrospective examination. For all cases patient age, gender, symptoms, and radiological chest findings were recorded. A total of 26 cytological respiratory samples (14 sputum smears, 9 FNAC, two BALs) including direct smears and 6 cell blocks from 9 patients were examined. In sputum smears the most remarkable findings were the presence of dark cotton ball masses with projections like spider legs and/or mouse tails (75% of the samples). Sulfur granules were observed in 4 (40%) of the sputum smears and within FNAC cases. Various respiratory cytology samples including sputum smears, FNAC and BALs can reveal cytomorphological findings diagnostic of pulmonary actinomycosis. Characteristic cytological findings compatible with a diagnosis of this infection include cotton ball masses and less frequently sulfur granules.
Topics: Actinomycosis; Animals; Biopsy, Fine-Needle; Cytodiagnosis; Humans; Mice; Retrospective Studies; Sulfur
PubMed: 34738778
DOI: 10.4081/monaldi.2021.1641 -
Turkish Journal of Medical Sciences Feb 2017Actinomycosis is a granulomatous disease caused by filamentous, gram-positive, anaerobic bacteria. Actinomycetes are commensal inhabitants of the oral cavity and... (Review)
Review
BACKGROUND/AIM
Actinomycosis is a granulomatous disease caused by filamentous, gram-positive, anaerobic bacteria. Actinomycetes are commensal inhabitants of the oral cavity and intestinal tract but acquire pathogenicity through invasion of breached or necrotic tissue.1397645907In abdominal actinomycosis (AA), the appendix and ileocecal region are usually involved. The aim of this study was to characterize patients diagnosed with AA and to establish the risk factors for appendiceal actinomycosis, including a short review of the literature.
MATERIALS AND METHODS
We conducted a prospective cohort study of all patients diagnosed with AA in the University Hospital Marques de Valdecilla (Santander-Cantabria) from January 2003 to October 2013. We also conducted a short review of the literature.
RESULTS
We characterized the epidemiological features of patients diagnosed with AA and risk factors for the involvement of the appendix, as most of the cases were misdiagnosed as appendicitis. Risk factors for appendiceal actinomycosis are no antecedents of carcinoma (P = 0.034) and previous incorrect diagnosis (P = 0.006).
CONCLUSION
AA is a rare and chronic infection. It is only reported in case reports in the literature. We present the largest series of patients diagnosed with AA. Half of the patients had morbidities, mostly carcinoma, and penicillin was the preferred treatment. More studies are needed to characterize patients affected with AA and to establish the correct treatment.
Topics: Actinomycosis; Aged; Appendicitis; Female; Humans; Male; Middle Aged; Prospective Studies; Risk Factors; Spain
PubMed: 28263474
DOI: 10.3906/sag-1511-52 -
Journal of Postgraduate Medicine Jan 1981
Topics: Actinomycosis; Fallopian Tube Diseases; Female; Humans; Middle Aged; Ovarian Diseases
PubMed: 7230072
DOI: No ID Found -
Nigerian Journal of Clinical Practice Oct 2022An extremely rare disease with a slow course, actinomycosis has a high mortality risk when not properly treated. Pulmonary actinomycosis is clinically and radiologically...
An extremely rare disease with a slow course, actinomycosis has a high mortality risk when not properly treated. Pulmonary actinomycosis is clinically and radiologically analogous with tuberculosis, foreign body aspiration, lung abscess, or lung cancer. Therefore, it often causes misdiagnosis or delay in diagnosis. A 65-year-old male patient, being followed up with the diagnosis of chronic obstructive pulmonary disease (COPD) and lung adenocarcinoma, was admitted to our outpatient clinic with complaints of chronic cough. On chest CT, a cavitary lesion in the upper lobe of the right lung was observed. Sputum Acid Fast Bacilli (AFB) was negative for 3 consecutive times, fungal direct examination was negative, and there was no growth in mycobacterium culture and fungal culture. Flexible bronchoscopy revealed a raised, hard, white-colored lesion on the mucosa obliterating the apical and anterior segment bronchial entrance of the right lung upper lobe. A diagnosis of actinomycosis was made with sulfur granules seen in the pathology as a result of biopsy and lavage. Detection of sulfur granules in biopsy is essential for the diagnosis of actinomycosis, and a nearly complete response is usually obtained with long-term antibiotic treatment. Alternative methods such as surgical debridement should be considered in cases that do not respond to antibiotic treatment.
Topics: Male; Humans; Aged; Actinomycosis; Lung Diseases; Lung; Anti-Bacterial Agents; Sulfur
PubMed: 36308251
DOI: 10.4103/njcp.njcp_1357_21