-
Journal of Infection in Developing... Jun 2021To review unusual actinomycosis cases that appeared as a diagnostic and therapeutic challenge at our institution and to present a literature review on the usual clinical... (Review)
Review
INTRODUCTION
To review unusual actinomycosis cases that appeared as a diagnostic and therapeutic challenge at our institution and to present a literature review on the usual clinical presentations.
METHODOLOGY
This retrospective review included all patients hospitalized for actinomycosis in a 10-year period at the University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia.
RESULTS
A total of 15 patients were hospitalized during the observed period, 9 (60%) females and 6 (40%) males. The localizations of actinomycosis were: pelvis (5), lungs (3), blood stream (2), colon (1), penis (1), stomach (1), skin (1), cervicofacial region (1). We present four unusual cases: subcutaneous actinomycotic abscess, actinomycosis of the stomach with underlying non-Hodgkin lymphoma, sepsis due to Actinomyces neslundii originated from chronic asymptomatic periapical tooth abscesses and actinomycosis of the distal part of the penile shaft.
CONCLUSIONS
Actinomycosis was a very rare clinical problem in our clinical practice (0.032% of all hospitalizations and 0.0034% of all outpatients) but among those cases classical clinical presentations were also very rare.
Topics: Actinomycosis; Aged; Croatia; Diagnosis, Differential; Female; Hospitalization; Humans; Male; Middle Aged; Retrospective Studies
PubMed: 34242202
DOI: 10.3855/jidc.13414 -
Annals of Palliative Medicine Jun 2021Actinomycosis of the parotid gland is very rare. We sought to examine the clinical features, treatment methods, and treatment results of actinomycosis of the parotid...
BACKGROUND
Actinomycosis of the parotid gland is very rare. We sought to examine the clinical features, treatment methods, and treatment results of actinomycosis of the parotid gland in our hospital.
METHODS
We retrospectively enrolled 5 patients with histopathologically identified actinomycosis of the parotid gland from January 2010 to May 2020.
RESULTS
This study included 3 male and 2 female subjects. All patients had a common complaint of the mass in the parotid gland. Skin necrosis was observed in one patient. However, skin necrosis and fistula track occurred in the other 2 patients after fine-needle aspiration cytology (FNAC). Based on the result of FNAC two cases of inflammation and abscess were identified. Four patients with suspicion of parotid tumors before surgery underwent parotidectomy, and one patient with consideration of parotid abscess underwent incision and drainage. After surgery, intravenous administration of antibiotics was performed for an average of 6 days and oral antibiotics were prescribed for about 2 months for patients with actinomycosis of the parotid gland.
CONCLUSIONS
In case of skin necrosis of the parotid lesion without evidence of a malignant tumor, or if FNAC does not reveal the presence of cancerous cells, and fistula tract or skin necrosis occurs after the FNAC, then actinomycosis of the parotid gland should be suspected. If the actinomycosis of the parotid gland was localized to the parotid gland and removed surgically, it would be sufficient to treat the patients with antibiotics for about 2 months while observing the clinical response.
Topics: Actinomycosis; Female; Humans; Male; Parotid Gland; Parotid Neoplasms; Retrospective Studies; Sensitivity and Specificity
PubMed: 33977749
DOI: 10.21037/apm-21-755 -
Thorax Jan 1973Six cases of pulmonary infection with and one case of infection with are described. The incidence of thoracic actinomycosis has declined recently and the classical...
Six cases of pulmonary infection with and one case of infection with are described. The incidence of thoracic actinomycosis has declined recently and the classical presentation with chronic discharging sinuses is now uncommon. The cases described illustrate some of the forms which the disease may take. Actinomycotic infection has been noted, not infrequently, to co-exist with bronchial carcinoma and a case illustrating this association is described. Sputum cytology as practised for the diagnosis of bronchial carcinoma has helped to identify the fungi in the sputum. Treatment is discussed, particularly the possible use of oral antibiotics rather than penicillin by injection.
Topics: Actinomycosis; Administration, Oral; Adult; Aged; Bronchial Neoplasms; Bronchography; Female; Humans; Injections, Intramuscular; Lung Diseases, Fungal; Male; Middle Aged; Nocardia Infections; Nocardia asteroides; Penicillins; Sputum
PubMed: 4568119
DOI: 10.1136/thx.28.1.73 -
Revista Da Sociedade Brasileira de... 2022
Topics: Actinomycosis; Diagnosis, Differential; Humans; Lung; Lung Diseases; Lung Neoplasms
PubMed: 35976334
DOI: 10.1590/0037-8682-0195-2022 -
Infection Apr 2011Actinomyces neuii, a species first described in 1994, has proven to be an exception in this genus on account of its aerobic growth, microscopic morphology (no... (Review)
Review
Actinomyces neuii, a species first described in 1994, has proven to be an exception in this genus on account of its aerobic growth, microscopic morphology (no branching), and the types and location of infections. Abscesses and infected atheromas are the most frequent types of infections, followed by infected skin structures, endophthalmitis, and bacteremias, including endocarditis. They are most likely of endogenous origin. To date, approximately 100 cases have been recorded in the literature. Intra-abdominal and intrathoracic infections, however, have not yet been described, and cases of classical actinomycosis seem to be extremely rare. Prognosis has generally been good with antibiotic and/or surgical treatment. Susceptibility to antibiotics has paralleled that of other Actinomyces spp.
Topics: Abscess; Actinomyces; Actinomycosis; Aerobiosis; Anti-Bacterial Agents; Bacteremia; Debridement; Endocarditis, Bacterial; Endophthalmitis; Humans; Plaque, Atherosclerotic; Skin Diseases, Bacterial
PubMed: 21340579
DOI: 10.1007/s15010-011-0088-6 -
Medical Principles and Practice :... 2022Hepatic actinomycosis (HA) is a rare infection with an indolent course, atypical clinical manifestations, nonspecific laboratory and imaging findings, and challenging... (Review)
Review
Hepatic actinomycosis (HA) is a rare infection with an indolent course, atypical clinical manifestations, nonspecific laboratory and imaging findings, and challenging diagnosis. We describe a case of a 35-year-old female who developed HA 2 weeks after gastrectomy. In addition, we analyzed clinical characteristics and outcome of 157 additional cases of HA identified in a 60-year literature review. Patients with HA were predominantly male (57%) and more than one-half were between 40 and 70 years of age. The infection was cryptogenic in 80.8% of cases. Risk factors for HA were identified in 63.1% of the patients. Clinical presentation included fever (57.7%), abdominal pain (52.1%), weight loss (45.1%), anorexia (27.5%), fatigue and chills (12.7% each), and malaise (12%) over a 2.35 ± 3.5 months period. Leukocytosis, elevated alkaline phosphatase, erythrocyte sedimentation rate, and C-reactive protein were the most frequent laboratory findings. Radiologic imaging revealed that the right lobe was more frequently affected (62.5%) with a single lesion found in two-thirds of cases. Diagnosis was achieved by histopathologic examination in 70.6% of cases. Cultures yielded Actinomyces in 45 instances, with A. israelii being the most frequent species. Less than one-half of the patients were treated only with antibiotics, while the others received combined medical and surgical treatment. The median duration of antibiotic therapy was 135 days. The presence of multiple lesions or solid tumor-like lesions (without liquefaction) was significantly associated with medical therapy alone. The outcome was favorable in most cases (94%). Although rarely encountered, HA should be considered in patients with a chronic or subacute inflammatory process of the liver to promptly diagnose and treat.
Topics: Actinomyces; Actinomycosis; Adult; Anti-Bacterial Agents; Female; Humans; Liver Abscess; Male
PubMed: 35038716
DOI: 10.1159/000521990 -
Diagnostic and Interventional Imaging Jun 2021
Topics: Actinomycosis; Diagnostic Imaging; Humans
PubMed: 33288490
DOI: 10.1016/j.diii.2020.11.002 -
The Annals of Otology, Rhinology, and... Mar 2022Infection caused by species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess...
BACKGROUND
Infection caused by species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis.
METHODS
Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region.
RESULTS
Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and prolonged antibiotic therapy. Thirty-four pediatric cases of cervicofacial actinomycosis are reviewed, 2 presented herein, and 32 from the published literature. There was equal gender distribution and the median age was 7.5 years. The most common site for infection was the submandibular area. Four (12%) of cases arose in pre-existing congenital lesions. Most patients were treated with penicillin-based antibiotics for a median duration of 6 months following surgical excision or debridement.
CONCLUSIONS
Actinomycosis is a rare infection of the cervicofacial region; secondary infections arising from congenital lesions of the head and neck are even more rare. A previously excised pre-auricular sinus and a sublingual dermoid cyst are not previously reported sites of infection. Actinomycosis should be suspected in chronically draining sinuses of the head and neck region and confirmed through anaerobic culture. Osteomyelitis is a potential complication and magnetic resonance (MR) imaging is warranted. Long-term antibiotic therapy with a penicillin-based antibiotic and surgical excision should be considered.
Topics: Actinomycosis, Cervicofacial; Adolescent; Child; Female; Humans; Male
PubMed: 34060325
DOI: 10.1177/00034894211021273 -
Asian Journal of Surgery Mar 2023
Topics: Humans; Colonic Neoplasms; Actinomycosis; Peritonitis; Diagnosis, Differential
PubMed: 36253265
DOI: 10.1016/j.asjsur.2022.09.069 -
The Turkish Journal of Pediatrics 2023Actinomycosis (ACM) is a rare infectious granulomatous disease caused by Actinomyces, a Grampositive, filamentous, saprophytic bacteria. There are several types of... (Review)
Review
BACKGROUND
Actinomycosis (ACM) is a rare infectious granulomatous disease caused by Actinomyces, a Grampositive, filamentous, saprophytic bacteria. There are several types of pediatric ACM, such as orocervicofacial (55%) and other less common forms: abdominopelvic and thoracic. We report a case of a 16-year-old who presented with abdominal ACM in the setting of acute appendicitis. After the case report, we provide a short literature review of pediatric appendicular ACM cases published.
CASE
A 16-year-old boy presented with nausea, vomiting, pain in the upper part of the abdomen and fever (37.5°C) lasting for 24 hours. On physical examination, the patient`s epigastrium and lower right abdominal quadrant were tender. White cell count and C-reactive protein (CRP) were elevated at 16,300/μL and 48.6mg/L respectively. Ultrasonography (US) showed appendicolith and edema of the appendiceal wall, focally with stratification as well as periappendiceal inflammation. The patient underwent a classic appendectomy, and the postoperative course was without complications. Histopathological analysis showed diffuse transmural neutrophilic infiltration of the appendix, focally with areas of necrosis and abscesses. There were numerous brightly eosinophilic colonies made of filamentous bacteria, located predominantly in submucosa. Special stains Grocott-Gomori`s Methenamine Silver and Gram were positive and a diagnosis of ACM was made.
CONCLUSIONS
Although appendicitis is very common in the general population, appendicitis associated with ACM is very rare, accounting for 0.02% - 0.06%, especially in the pediatric population. Diagnosis can be very challenging because they usually present with non-specific symptoms, and can form masses that mimic malignancies. Although rare, clinicians and pathologists should be aware of this entity. Satisfactory results and complete cure are achieved with adequate antibiotic therapy and surgery. In most cases, if there are no associated diseases, early and accurate diagnosis ensure an excellent prognosis.
Topics: Male; Humans; Child; Adolescent; Appendix; Appendicitis; Actinomycosis; Abscess; C-Reactive Protein
PubMed: 37661685
DOI: 10.24953/turkjped.2023.33