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Erbagci A, Toksöz Yıldırım AN. Challenging Diagnosis of Abdominal Actinomycosis: A Case Report of a 59-Year-Old Male With Acute Appendicitis-Like Presentation. Cureus 2024; 16:e70966. [PMID: 39376974 PMCID: PMC11456747 DOI: 10.7759/cureus.70966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2024] [Indexed: 10/09/2024] Open
Abstract
Abdominal actinomycosis, a rare and often misdiagnosed condition caused by Actinomyces israelii, typically a commensal organism in the oral cavity and gastrointestinal tract, can become pathogenic, leading to chronic granulomatous infections that mimic various abdominal pathologies, including malignancies. We present a case of a 59-year-old male with coronary artery disease and type 2 diabetes who presented with severe abdominal pain, initially diagnosed as acute appendicitis. During exploratory laparotomy, an ileocecal band mimicking a congenital anomaly was discovered. Histopathological examination confirmed abdominal actinomycosis, revealing clusters of Actinomyces bacteria surrounded by acute inflammatory cells. The patient was successfully treated with surgical intervention and prolonged penicillin therapy, with no recurrence during a four-month follow-up. This case highlights the diagnostic challenges posed by abdominal actinomycosis and emphasizes the importance of considering it in the differential diagnosis of abdominal masses and appendicitis-like symptoms.
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Affiliation(s)
- Ahmet Erbagci
- Pathology, Istanbul Medeniyet University, Istanbul, TUR
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Ali M, Razok A, Ziglam H. A 5-year retrospective study of Actinomyces odontolyticus bacteremia in the state of Qatar, case series. Ann Med Surg (Lond) 2022; 76:103583. [PMID: 35495409 PMCID: PMC9052238 DOI: 10.1016/j.amsu.2022.103583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction and importance Manifestations of infection by A. odontolyticus include thoracic, abdominal, pelvic, and central nervous system disease. In the four decades following its isolation, more than 20 cases of invasive infections were reported in multiple geographic locations including the United States and Europe. As such, A. odontolyticus is an emerging bacterium and related research is encouraged for further characterization of its prevalence and clinical significance. Our case series represents the first case series about A. odontolyticus bacteremia in the state of Qatar. Methods We are reporting 15 cases with isolated A. odontolyticus positive blood cultures at Hamad Medical Corporation, State of Qatar from 1/Jan/2016 to 1/Nov/2020. Electronic health records (EHR) of patients who were identified to have positive blood cultures were accessed and the demographics and other clinically related data were collected and mentioned in this manuscript, after obtaining the appropriate approval from the Corporation Medical Research Council (MRC). Outcomes We are reporting 15 cases with isolated A. odontolyticus positive blood cultures at Hamad Medical Corporation, State of Qatar from 1/Jan/2016 to 1/Nov/2020. Conclusion 12 of the 15 reported cases were considered significant and received a complete course of antimicrobial therapy. The patients presented with a wide variety of clinical pictures and were of variable age.
A. odontolyticus is an emerging bacterium with increasingly reported cases. It is an anaerobic, filamentous gram-positive bacterium. It is associated with cervical, thoracic, abdominal, and pelvic infections. It can affect a wide spectrum of patient population.
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Balasuriya HD, Keshava A. Abdominal actinomycosis mimicking metastatic right colonic cancer: a diagnostic dilemma. ANZ J Surg 2021; 92:1275-1276. [PMID: 34658123 DOI: 10.1111/ans.17282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Hasitha D Balasuriya
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Anil Keshava
- Colorectal Surgical Unit, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Department of Colorectal Surgery, Macquarie University Hospital, Macquarie University, Sydney, New South Wales, Australia
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Goussard P, Rabie H, Marshall M, Mfingwana L, Morrison J, Ismal Z, Retief F, Nel P, Da Costa D, Andronikou S, Schubert P. Endobronchial actinomycosis in a child. Pediatr Pulmonol 2021; 56:3429-3432. [PMID: 34265174 DOI: 10.1002/ppul.25550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/08/2021] [Accepted: 06/22/2021] [Indexed: 11/10/2022]
Abstract
Actinomycosis is a rare, indolent and invasive infection caused by Actinomyces species. Pulmonary actinomycosis is very rarely seen in the paediatric population. The classic radiological presentation of thoracic involvement of actinomycosis includes lower lobe consolidation, empyema and periostitis of the ribs. We report a case of endobronchial actinomycosis in a child diagnosed on endobronchial biopsy and bronchoalveolar lavage (BAL). Bronchoscopy can be dangerous when performed on these cases, as there is a risk of severe bleeding and large airway obstruction, as was the case with this patient.
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Affiliation(s)
- Pierre Goussard
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Helena Rabie
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Michelle Marshall
- Division of Cytology, Tygerberg Hospital, National Health Laboratory Service, Cape Town, South Africa
| | - Lunga Mfingwana
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Julie Morrison
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Zane Ismal
- Division of Cardiothoracic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Francois Retief
- Department of Anaesthesiology and Critical Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Pieter Nel
- Division of Medical Microbiology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| | - Dawood Da Costa
- Division of Medical Microbiology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| | - Savvas Andronikou
- Department of Paediatric Radiology, The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, United States of America
| | - Pawel Schubert
- Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
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Gajdács M, Urbán E. The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era. Antibiotics (Basel) 2020; 9:E524. [PMID: 32824418 PMCID: PMC7459602 DOI: 10.3390/antibiotics9080524] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 12/16/2022] Open
Abstract
Actinomycosis is a chronic, suppurative, granulomatous infectious disease, caused by different species of Actinomyces bacteria. To date, 26 validly published Actinomyces species have been described as part of a normal human microbiota or from human clinical specimens. Due to the rapid spread of new, modern diagnostic procedures, 13 of 26 of these species have been described in this century and the Actinomycetaceae family has undergone several taxonomic revisions, including the introduction of many novel species termed Actinomyces-like organisms (ALOs). There is scarce data available on the role of these novel bacterial species in various infectious processes in human medicine. The aim of this review is to provide a comprehensive overview of Actinomyces and closely related organisms involved in human diseases-with a special focus on newly described species-in particular their role in genitourinary tract infections in females and males.
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Affiliation(s)
- Márió Gajdács
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary;
- Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary
| | - Edit Urbán
- Institute of Translational Medicine, Faculty of Medicine, University of Pécs, 7624 Pécs, Hungary
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Manterola C, Grande L, Riffo‐Campos ÁL, Salgado C, Otzen T. Clinical aspects of abdominal actinomycosis: a systematic review. ANZ J Surg 2020; 90:1465-1468. [DOI: 10.1111/ans.16141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Carlos Manterola
- Department of SurgeryUniversidad de La Frontera Temuco Chile
- Center of Excellence in Morphological and Surgical Studies (CEMyQ)Universidad de La Frontera Temuco Chile
- PhD Program in Medical SciencesUniversidad de La Frontera Temuco Chile
| | - Luis Grande
- Department of SurgeryHospital del Mar/Institut Hospital del Mar d'Investigacions Mèdiques Barcelona Spain
- Department of SurgeryUniversitat Autònoma de Barcelona Barcelona Spain
| | | | - Carla Salgado
- Department of MedicineUniversidad del Azuay Cuenca Ecuador
| | - Tamara Otzen
- Center of Excellence in Morphological and Surgical Studies (CEMyQ)Universidad de La Frontera Temuco Chile
- PhD Program in Medical SciencesUniversidad de La Frontera Temuco Chile
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Abstract
Actinomycosis is a rare bacterial disease characterized by chronic or subacute suppurative inflammation. Abdominal actinomycosis is rarer and accounts for approximately 20% of all actinomycosis cases. In the literature, patients who underwent surgery for actinomycosis mimicking malignant tumors have been reported. Most of these patients had mucosal trauma and inflammation signs. It is often difficult to diagnose abdominal actinomycosis preoperatively and often impossible to distinguish it from a malignant tumor. We present a case that preoperatively was diagnosed as a malignant tumor but pathological evaluation reported to be diverticulitis and actinomycosis. This case can increase the awareness about this disease, which is possible to be treated non-surgically.
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Affiliation(s)
- Ramazan Sari
- Department of General Surgery, Baskent University, Adana, Turkey
| | - Murat Kuş
- Department of General Surgery, Baskent University, Adana, Turkey
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Abstract
Infectious diseases are one of the main causes of morbidity and mortality worldwide. With new pathogens continuously emerging, known infectious diseases reemerging, increasing microbial resistance to antimicrobial agents, global environmental change, ease of world travel, and an increasing immunosuppressed population, recognition of infectious diseases plays an ever-important role in surgical pathology. This becomes particularly significant in cases where infectious disease is not suspected clinically and the initial diagnostic workup fails to include samples for culture. As such, it is not uncommon that a lung biopsy becomes the only material available in the diagnostic process of an infectious disease. Once the infectious nature of the pathological process is established, careful search for the causative agent is advised. This can often be achieved by examination of the hematoxylin and eosin-stained sections alone as many organisms or their cytopathic effects are visible on routine staining. However, ancillary studies such as histochemical stains, immunohistochemistry, in situ hybridization, or molecular techniques may be needed to identify the organism in tissue sections or for further characterization, such as speciation.
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Affiliation(s)
- Annikka Weissferdt
- Associate Professor, Department of Pathology, Division of Pathology and Laboratory Medicinec, The University of Texas MD Anderson Cancer Center, Houston, TX USA
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Aragao A, Biemer J, Barkan GA, Pambuccian SE. Splendore‐Hoeppli phenomenon in a fine needle aspirate of cervicofacial actinomycosis. Diagn Cytopathol 2018; 47:238-243. [DOI: 10.1002/dc.24025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/18/2018] [Accepted: 06/18/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Alessa Aragao
- Department of PathologyLoyola University Medical Center Maywood Illinois
| | - John Biemer
- Department of PathologyLoyola University Medical Center Maywood Illinois
| | - Guliz A. Barkan
- Department of PathologyLoyola University Medical Center Maywood Illinois
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10
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Ravindra N, Sadashiva N, Mahadevan A, Bhat DI, Saini J. Central Nervous System Actinomycosis—A Clinicoradiologic and Histopathologic Analysis. World Neurosurg 2018; 116:e362-e370. [DOI: 10.1016/j.wneu.2018.04.205] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 11/16/2022]
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Egal A, Etienney I, Beate H, Fléjou JF, Cuenod CA, Atienza P, Bauer P. Diagnosis and Management of a Cryptoglandular Actinomycotic Fistula-in-Ano: An Update on 7 New Cases and a Review of the Literature. Ann Coloproctol 2018; 34:152-156. [PMID: 29991204 PMCID: PMC6046537 DOI: 10.3393/ac.2017.07.23] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/23/2017] [Indexed: 12/11/2022] Open
Abstract
Purpose Primary anal actinomycosis of cryptoglandular origin, a rare cause of anal suppurative disease, requires specific management to be cured. The aims of this retrospective study were to describe clinical, morphological, and microbiological features of this entity and to evaluate management practices for new cases observed since 2001. Methods This was a retrospective case series conducted at the Diaconesses-Croix Saint-Simon Hospital in Paris. Results From January 2001 to July 2016, 7 patients, 6 males and 1 female (median, 49 years), presenting with an actinomycotic abscess with a cryptoglandular anal fistula were included for study. The main symptom was an acute painful ischioanal abscess. One patient exhibited macroscopic small yellow granules (“sulfur granules”), another “watery pus” and a third subcutaneous gluteal septic metastasis. All patients were overweight (body mass index ≥ 25 kg/m2). Histological study of surgically excised tissue established the diagnosis. All the patients were managed with a combination of classical surgical treatment and prolonged antibiotic therapy. No recurrence was observed during follow-up, the median follow-up being 3 years. Conclusion Actinomycosis should be suspected particularly when sulfur granules are present in the pus, patients have undergone multiple surgeries or suppuration has an unusual aspect. Careful histological examination and appropriate cultures of pus are needed to achieve complete eradication of this rare, but easily curable, disease.
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Affiliation(s)
- Axel Egal
- Department of Proctological Surgery, Diaconesses-Croix Saint-Simon Hospital, Paris, France
| | - Isabelle Etienney
- Department of Proctological Surgery, Diaconesses-Croix Saint-Simon Hospital, Paris, France
| | - Heym Beate
- Department of Microbiology, Diaconesses-Croix Saint-Simon Hospital, Paris, France
| | | | | | - Patrick Atienza
- Department of Proctological Surgery, Diaconesses-Croix Saint-Simon Hospital, Paris, France
| | - Pierre Bauer
- Department of Proctological Surgery, Diaconesses-Croix Saint-Simon Hospital, Paris, France
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Moll FH, Halling T, Hansson N, Fangerau H. ["When all of you will be forgotten, the name Israel will still be shining" : James Israel (1848-1926): a career in the German Empire and his nomination for the Nobel Prize]. Urologe A 2017; 56:369-381. [PMID: 28246758 DOI: 10.1007/s00120-017-0326-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In 1902, the Berlin Jewish urologist James Israel was nominated for the Nobel Prize in physiology or medicine. Taking scholar, social, and political aspects into consideration, this biographical essay traces how James Israel gained a sound scientific reputation especially in kidney surgery within Imperial Germany and its antisemitic attitude and how he promoted urology to become a specialty in its own right.
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Affiliation(s)
- Friedrich H Moll
- Institut für Geschichte, Theorie und Ethik der Medizin, Heinrich Heine Universität, Düsseldorf, Deutschland. .,Museum, Bibliothek und Archiv, Deutsche Gesellschaft für Urologie e. V., Düsseldorf, Deutschland. .,Urologische Klinik, Kliniken der Stadt Köln gGmbH, Neufelder Straße 32, 51067, Köln, Deutschland.
| | - Thorsten Halling
- Institut für Geschichte, Theorie und Ethik der Medizin, Heinrich Heine Universität, Düsseldorf, Deutschland
| | - Nils Hansson
- Institut für Geschichte, Theorie und Ethik der Medizin, Heinrich Heine Universität, Düsseldorf, Deutschland
| | - Heiner Fangerau
- Institut für Geschichte, Theorie und Ethik der Medizin, Heinrich Heine Universität, Düsseldorf, Deutschland
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13
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[Pelvic actinomycosis: Diagnostic and therapeutic aspects]. ACTA ACUST UNITED AC 2016; 44:168-74. [PMID: 26857044 DOI: 10.1016/j.gyobfe.2016.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 11/26/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Actinomycosis is a rare little known granulomatous suppurative disease, more common in women, aided by the use of contraceptive purposes intrauterine device (IUD). Pelvic location is the rarest with an extension to adjacent organs making preoperative diagnosis difficult and misleading clinical presentation. Early diagnosis of this affection determines the therapeutic strategy and avoids mutilating interventions especially in young women. METHODS We reviewed the record of women who consulted the department of obstetrics and gynecology at Ben Arous hospital (Tunisia) between January 2003 and December 2013 for a pelvic pain syndrome and in whom diagnosis of actinomycosis was suspected by clinical and imaging and confirmed by pathology. RESULTS Eight cases of gynecologic abdominopelvic actinomycosis were diagnosed during the study period. Seven patients were carriers of an intrauterine device, with an average duration of 5 years wearing. Functional signs were essentially pelvic pain and fever. Physical examination of patients mainly showed two clinical presentations: a pelvic tumor syndrome or abdominopelvic and an array of pelvic abscess or pelvic inflammatory disease. Radiological investigations were allowed to suspect the diagnosis of actinomycosis only in one patient, in whom percutaneous biopsy confirmed the histological diagnosis without resorting to a surgical procedure. Operative procedures performed were varied as appropriate. The diagnosis of actinomycosis was made by pathology without any cases of bacterial isolation. All patients received antibiotic treatment with penicillin. The subsequent evolution was favorable. CONCLUSION The diagnosis of actinomycosis should be considered in any invasive abdominal mass of neoplastic appearance and in case of table of genital infection especially in patients bearing IUD for 5 years or more.
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Akhtar M, Zade MP, Shahane PL, Bangde AP, Soitkar SM. Scalp actinomycosis presenting as soft tissue tumour: A case report with literature review. Int J Surg Case Rep 2015; 16:99-101. [PMID: 26439419 PMCID: PMC4643463 DOI: 10.1016/j.ijscr.2015.09.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 09/22/2015] [Accepted: 09/22/2015] [Indexed: 11/27/2022] Open
Abstract
Cutaneous actinomycosis presenting as tumoriform mass is rare. Histopathological confirmation is mandatory with visualization of sulfur granules which is seen only in 25% cases and can be missed in small biopsy specimen. Management of a classical case of cutaneous actinomycosis is high dose IV antibiotics for 4–6 weeks followed by oral penicillin or amoxycillin for 6–12 months. Surgical resection is a useful adjuvant therapy specially in large, disfiguring masses not responding to treatment and excisional biopsy is helpful in establishing histopathological confirmation. Introduction Actinomycosis is a rare subacute or chronic bacterial infection caused by Gram positive, anaerobic or microaerophilic bacilli. It is characterized by suppuration, abscess formation, tissue fibrosis, draining sinuses & rarely as a soft tissue mass mimicking a tumor. Case report A 16 year old boy sustained a trauma over right forehead & wound after which patient presented with swelling over right forehead which was excised and was histopathologically reported as angiomatous lesion. Patient presented with recurrent swelling with ulceration over the same site. CT scan showed soft tissue mass with periosteal reaction of right frontal bone. Wide local excision with removal of periosteum was carried out. Raw area was covered with rotational scalp flap. Histopathology of the excised specimen showed features of actinomycosis. Discussion Cutaneous actinomycosis presenting as pseudocarcinomatous or sarcomatous mass is rare. Trauma is a common preceding event which was observed in present case. Histopathological confirmation is mandatory with visualization of sulfur granules. It is managed by high dose IV antibiotics. Surgical resection is a useful adjuvant therapy specially in large, disfiguring masses not responding to medical treatment and where excisional biopsy is helpful in establishing the diagnosis surgical excision alone is not curative, post operative long term antibiotics are adjuvant therapy to avoid recurrence. Conclusion Actinomycosis of scalp skin is a rare entity and tumor like presentation is still uncommon. Lesions not resolving with routine antibiotics therapy should be suspected clinically as actinomycosis and treated with high dose antibiotics as histopathology from small biopsy is unreliable.
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Affiliation(s)
- Murtaza Akhtar
- Dept. of Surgery, NKP Salve Institute Of Medical Sciences, Digdoh Hills, Hingna Road, Nagpur 440019, India.
| | - Manish P Zade
- Dept. of Plastic Surgery, NKP Salve Institute Of Medical Sciences, Digdoh Hills, Hingna Road, Nagpur 440019, India
| | - Pawan L Shahane
- Dept. of Plastic Surgery, NKP Salve Institute Of Medical Sciences, Digdoh Hills, Hingna Road, Nagpur 440019, India
| | - Akshay P Bangde
- Dept. of Surgery, NKP Salve Institute Of Medical Sciences, Digdoh Hills, Hingna Road, Nagpur 440019, India
| | - Sagar M Soitkar
- Dept. of Surgery, NKP Salve Institute Of Medical Sciences, Digdoh Hills, Hingna Road, Nagpur 440019, India
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Abstract
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.
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Petersen S, Würschmidt F, Gaul H, Caselitz J, Schwenk W. Actinomyces infection mimicking tumor-progression in rectal cancer under neoadjuvant therapy. Acta Oncol 2012; 51:270-2. [PMID: 22263972 DOI: 10.3109/0284186x.2011.604346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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De D, Dogra S, Kanwar AJ, Saikia UN. Actinomycosis presenting as a destructive ulcerated plaque on the palate and gingiva. J Am Acad Dermatol 2011; 65:1235-6. [PMID: 22082848 DOI: 10.1016/j.jaad.2009.02.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2008] [Revised: 02/18/2009] [Accepted: 02/22/2009] [Indexed: 10/15/2022]
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Koo YJ, Kwon YS, Shim JU, Mok JE. Predictors associated with severity of pelvic actinomycosis. J Obstet Gynaecol Res 2011; 37:1792-6. [PMID: 21794000 DOI: 10.1111/j.1447-0756.2011.01608.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the clinical features of pelvic actinomycosis and to identify predictive factors associated with severity of pelvic actinomycosis. MATERIAL AND METHODS Medical records of 25 patients diagnosed with pelvic actinomycosis and treated by surgery between September 1994 and March 2010 at Cheil General Hospital and Women's Healthcare Center were reviewed retrospectively. RESULTS Of the 25 patients, 15 (60%) had mild pelvic actinomycosis with adhesion and abscess but no complications. The other 10 patients (40%) had an aggressive state of pelvic actinomycosis accompanied by diverse complications, such as hydroureter, abscess rupture, bowel obstruction and cystoenteric fistula. The aggressive actinomycosis correlated with fever, higher neutrophil percentage and a higher white blood cell count to hemoglobin ratio compared to those with mild pelvic actinomycosis. However, there were no significant differences in the use of intrauterine devices, C-reactive peptide level or mass size between those with mild and aggressive pelvic actinomycosis. CONCLUSION Using the clinical factors, such as fever, neutrophil percentage and white blood cell count to hemoglobin ratio, the surgeons can more accurately predict the severity of pelvic actinomycosis, thus being helpful for more proper disease management.
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Affiliation(s)
- Yu-Jin Koo
- Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea
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Clarke TM, Citron DM, Towfigh S. The Conundrum of the Gram-Positive Rod: Are We Missing Important Pathogens in Complicated Skin and Soft-Tissue Infections? A Case Report and Review of the Literature. Surg Infect (Larchmt) 2010; 11:65-72. [DOI: 10.1089/sur.2008.085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tatyan M. Clarke
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | - Shirin Towfigh
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
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Privitera A, Milkhu CS, Datta V, Rodriguez-Justo M, Windsor A, Cohen CR. Actinomycosis of the sigmoid colon: A case report. World J Gastrointest Surg 2009; 1:62-4. [PMID: 21160798 PMCID: PMC2999117 DOI: 10.4240/wjgs.v1.i1.62] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 09/15/2009] [Accepted: 09/22/2009] [Indexed: 02/06/2023] Open
Abstract
Abdominal actinomycosis is a chronic suppurative infection caused by Actinomyces species. The ileo-cecal region is most commonly affected, while the left side of the colon is more rarely involved. The infection has a tendency to infiltrate adjacent tissues and is therefore rarely confined to a single organ. Presentation may vary from non specific symptoms and signs to an acute abdomen. A computed tomography scan is helpful in identifying the inflammatory process and the organs involved. It also allows visual guidance for percutaneous drainage of abscesses, thus aiding diagnosis. Culture is difficult because of the anaerobic character and slow growth of actinomycetes. Colonoscopy is usually normal, but may shows signs of external compression. Preoperative diagnosis is rare and is established only in less than 10% of cases. In uncomplicated disease, high dose antibiotic therapy is the mainstay of treatment. Surgery is often performed because of a difficulty in diagnosis. Surgery and antibiotics are required in the case of complicated disease. Combined medical and surgical treatment achieves a cure in about 90% of cases. The authors report a case of sigmoid actinomycosis where diagnosis was made from the histology, and a review of the literature is presented.
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Affiliation(s)
- Antonio Privitera
- Antonio Privitera, Charanjit Singh Milkhu, Vivek Datta, Alastair Windsor, Charles Richard Cohen, Department of Surgery, University College London Hospitals, London NW1 2BU, United Kingdom
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Choi MH, Hong DG, Seong WJ, Lee YS, Park IS. Pelvic actinomycosis confirmed after surgery: single center experience. Arch Gynecol Obstet 2009; 281:651-6. [PMID: 19565255 DOI: 10.1007/s00404-009-1157-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Accepted: 06/09/2009] [Indexed: 12/01/2022]
Abstract
PURPOSE To review pelvic actinomycosis confirmed by surgery and summarize clinical aspects. METHOD The authors retrospectively reviewed 16 cases that underwent surgical procedures for pelvic actinomycosis between January 1998 and January 2006. RESULTS Twelve of the cases (75%) had used intrauterine contraceptive devices for a period of between 8 months and 12 years (mean duration: 5.2 years). Most of the cases presented elevated white blood cell count, neutrophil percentage, CRP value and CA 125 value. Four of the eight cases that were checked by computed tomography presented the possibility of pelvic malignancies. All patients underwent surgery. The mean duration of intravenous antibiotics was 11.8 days and that of peroral antibiotics was 4.3 months. After treatment, there were no complications or recurrences, with the exception of one case of preoperative unilateral ureter obliteration. CONCLUSION In diagnosis of pelvic actinomycosis, it is not necessary to consider whether an intrauterine device was being used or not. To distinguish from pelvic malignancy, various methods (including imaging study) should be considered. As for antibiotic treatment, it is believed that shorter and high dose antibiotics therapy will be sufficient treatment.
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Affiliation(s)
- Min H Choi
- Department of Obstetrics and Gynecology, Kyungpook National University School of Medicine, Daegu, Korea
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Ovarian and vesical actinomycosis: a case report and literature review. Arch Gynecol Obstet 2008; 279:591-3. [PMID: 18762960 DOI: 10.1007/s00404-008-0770-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 08/12/2008] [Indexed: 10/21/2022]
Abstract
We present a patient with a tubo-ovarian abscess pathologically confirmed to be actinomycosis in a 44-year-old woman with an intrauterine device (IUD). An ultrasound showed that the IUD was imposed on an apparently degenerated myoma. A pelvic MRI was performed to differentiate the uterine findings from a sarcoma. The MRI showed a heterogeneous pelvic mass and a bladder mass suggesting chronic inflammation caused by an organism such as actinomycosis. An exploratory laparotomy was performed, which revealed a right tubo-ovarian mass with abscess formation as well as a bladder mass. A subtotal hysterectomy, right salpingoophorectomy, partial cystectomy, and appendectomy were performed in addition to drainage of the abscess. Histopathological examination revealed a tubo-ovarian abscess and a bladder mass with colonies of actinomycoses.
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Abstract
Pelvic actinomycosis is difficult to diagnose. In most cases, it is not diagnosed until after surgery. If this condition is diagnosed preoperatively, it can be treated in many cases. Three cases of actinomycosis are reported here. Three women with intrauterine devices (IUD) each presented with lower abdominal pain and pelvic mass, and elevated white blood cell count and C-reactive protein. Left salpingo-oophorectomy was performed for one the women. The pathological diagnosis was actinomycosis. For the other two women, a Gram or Papanicolaou stain of the IUD sample showed actinomycetes. They were discharged after intravenous administration of penicillin without surgery.
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Affiliation(s)
- Shigeki Taga
- Department of Obstetrics and Gynecology, Sumitomo Besshi Hospital, 3-1 Ojicho, Niihama, Ehime, Japan.
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Abstract
Thoracic actinomycosis is uncommon, indolent, and often not considered in children with chest wall masses, pneumonia, or empyema. We present a 27-month-old girl without risk factors for thoracic actinomycosis whose initial diagnosis was malignancy. She recovered completely after lobectomy, debridement, and antimicrobial therapy. Literature review since 1975 identified 54 additional cases; most were male, older, and had underlying risk factors.
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Baierlein SA, Wistop A, Looser C, Peters T, Riehle HM, von Flüe M, Peterli R. Abdominal actinomycosis: a rare complication after laparoscopic gastric bypass. Obes Surg 2007; 17:1123-6. [PMID: 17953250 DOI: 10.1007/s11695-007-9189-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A 33-year-old, morbidity obese woman underwent a laparoscopic Roux-en-Y gastric bypass in November 2004. She presented 18 months later with a history of recurrent pain in the upper region of the abdomen and severe vomiting. Radiologic and endoscopic evaluations revealed wall thickening in the transverse colon and a solid tumor near the liver. Therefore, a sonography-guided biopsy of the tumor was performed. Cytopathological examination revealed actinomycosis. Thus, therapy with penicillin was started, after which the parameters associated with the infection decreased. The symptoms persisted, however, and the decision was made to operate on the patient to resect the abdominal masses. Nearly 90% of the masses could be removed. Histological analysis showed a fibro-productive inflammation with an actinomycotic etiology. Antibiotic therapy with penicillin was continued for 6 months. Actinomycosis must be considered in the differential diagnosis of patients with abdominal mass, wall thickening of the intestine, and other such symptoms, including abdominal pain following bariatric surgery, even many years after the intervention.
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Dahiya K, Chechi K, Sharma D, Sirohiwal D, Mathur S, Batra C. Pelvic Actinomycosis Associated with an Intrauterine Device. J Gynecol Surg 2007. [DOI: 10.1089/gyn.2007.b-02278-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Krishna Dahiya
- Department of Obstetrics and Gynecology and Pathology, Pt. Bhagwat Dayal Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Kunica Chechi
- Department of Obstetrics and Gynecology and Pathology, Pt. Bhagwat Dayal Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Damyanti Sharma
- Department of Obstetrics and Gynecology and Pathology, Pt. Bhagwat Dayal Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Daya Sirohiwal
- Department of Obstetrics and Gynecology and Pathology, Pt. Bhagwat Dayal Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Satyavir Mathur
- Department of Obstetrics and Gynecology and Pathology, Pt. Bhagwat Dayal Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Charu Batra
- Department of Obstetrics and Gynecology and Pathology, Pt. Bhagwat Dayal Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
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Abstract
Cervicofacial actinomycosis should be included in the differential diagnosis of any soft tissue swelling in the head and neck region, particularly if malignancy or a granulomatous disease is suspected. The diagnosis often is overlooked because of this entity's ability to mimic other conditions. Mandibular osteomyelitis also is underappreciated by many clinicians in their assessment of head and neck infections. Most cases are traced to an odontogenic source, with periapical tooth abscess and posttraumatic or surgical complication as key antecedent events.
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Affiliation(s)
- Abdu A Sharkawy
- Department of Medicine, Division of Infectious Diseases, University of Toronto and Toronto Western Hospital, 8-East Wing Room 418, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada.
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Abstract
In November 1839 the young university lecturer Bernhard (von) Langenbeck (1810-1887) published the first description of a fungus as aetiological agent of an oro-pharyngeal and oesophageal candidosis. We present his in English translated paper entitled 'Finding of fungi on the mucous membrane of the gullet of a typhoid fever corpse' (Germ.) in 'Neue Notizen aus dem Gebiete der Natur- und Heilkunde' (Froriep). There are interesting particulars in Langenbeck's description and discussion. The publication happened at the same time as that by Johann Lukas Schoenlein about fungi as the cause of the favus lesions. In this time Langenbeck lived at Göttingen. Later he went to Kiel and Berlin and became one of the most prominent surgeons of the 19th century. He sponsored the founding of the German Surgical Society, the Berlin Medical Society and the 'Archiv für Klinische Chirurgie'. In 1864 he was ennobled. Some of his assistants were Th. Billroth, R.U. Kroenlein, F. von Esmarch, and F. Trendelenburg.
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Affiliation(s)
- M Knoke
- Faculty of Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany.
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Affiliation(s)
- Rutger J Lely
- Department of Radiology, St Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, the Netherlands.
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Hsu JT, Lo HC, Jan YY, Chen HM. Actinomycosis mimicking recurrent carcinoma after Whipple's operation. World J Gastroenterol 2005; 11:1722-1724. [PMID: 15786560 PMCID: PMC4305964 DOI: 10.3748/wjg.v11.i11.1722] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Revised: 10/02/2004] [Accepted: 11/19/2004] [Indexed: 02/07/2023] Open
Abstract
Actinomycosis is a rare, chronic, spreading, suppurative, granulomatous and fibrosing infection. Actinomyces are normal inhabitants of the oral cavity and gastrointestinal tract. They rarely cause disease and are seldom reported as pathogens. Herein, we reported on a 69-year-old male patient who had undergone Whipple's operation due to ampulla Vater carcinoma, and became infected with actinomycosis at the pancreaticojejunostomy, which mimicked a recurrent malignancy. He was treated with radical resection of the mass at the pancreaticojejunostomy and had an uneventful postoperative course.
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Affiliation(s)
- Jun-Te Hsu
- Department of General Surgery, Chang Gung Memorial Hospital, Kweishan, Taoyuan, Taiwan, China
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Coremans G, Margaritis V, Van Poppel HP, Christiaens MR, Gruwez J, Geboes K, Wyndaele J, Vanbeckevoort D, Janssens J. Actinomycosis, a rare and unsuspected cause of anal fistulous abscess: report of three cases and review of the literature. Dis Colon Rectum 2005; 48:575-81. [PMID: 15875298 DOI: 10.1007/s10350-004-0809-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Primary perianal actinomycosis is rare. Sporadic cases, with lesions varying in extent have been reported. The infection is caused by the bacterium Actinomyces, which often is a saprophyte. Male gender and diabetes are risk factors, but the exact pathogenic mechanism remains speculative. The diagnosis is a challenge and often delayed, with a protracted history of masses and sinuses extending into the gluteal and genital region. The treatment, a combination of surgery and antibiotics, is poorly standardized. We report three cases and compare their characteristics to those of published cases, found by a computerized literature search (1968-2002). The lesions, a simple fistula-in-ano or a mass, were diagnosed in an early stage in all three patients. The infection always spread into the scrotum. There were no risk factors other than gender, except in one patient. The diagnosis was suspected by the observation of draining sulfur granules and promptly confirmed by histology in the three cases. All patients healed with antibiotics in addition to simple surgical procedures. Treatment consisted of amoxicillin for two weeks in two cases and more extended antimicrobial treatment in the third. These findings are contrasting with the classic picture of perianal actinomycosis. It is concluded that perianal actinomycosis can occur in the absence of risk factors and that early diagnosis requires a high degree of suspicion. An infection with Actinomyces should be suspected in the presence of lesions containing watery purulent material with sulfur granules. The indication for extended antibiotherapy combined with sphincter damaging surgery may need to be revised in the presence of early detection.
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Affiliation(s)
- G Coremans
- Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium.
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Abstract
We describe two immunosuppressed female patients with fever and Actinomyces odontolyticus bacteremia, a combination documented once previously in an immunocompetent male patient. The patients were treated with doxycycline and clindamycin; these drugs, with beta-lactams, are effective treatment for A. odontolyticus infections.
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Affiliation(s)
- Lawrence A Cone
- Eisenhower Medical Center, Rancho Mirage, California 92270, USA.
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Pulverer G, Schütt-Gerowitt H, Schaal KP. Human cervicofacial actinomycoses: microbiological data for 1997 cases. Clin Infect Dis 2003; 37:490-7. [PMID: 12905132 DOI: 10.1086/376621] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2002] [Accepted: 04/04/2003] [Indexed: 11/03/2022] Open
Abstract
Actinomycoses are sporadically occurring endogenous polymicrobial inflammatory processes, in which fermentative actinomycetes of the genera Actinomyces, Propionibacterium, or Bifidobacterium act as the principal pathogens. Difficulties in diagnosing the disease in a timely and reliable fashion have led clinicians and microbiologists to grossly underestimate its medical importance. Therefore, we evaluated microbiological and selected clinical data derived from 1997 culture-positive cases of human cervicofacial actinomycoses examined in our laboratories during 1972-1999. The causative actinomycetes belonged to at least 9 different species, among which Actinomyces israelii and Actinomyces gerencseriae predominated. The well-known predisposition of male patients to acquire the disease varied with age and appeared to be especially pronounced in patients aged 20-60 years, the highest incidence being found in female patients aged 11-40 years and in male patients aged 21-50 years. The relevant procedures necessary for diagnosing human actinomycoses reliably, as well as details of their complex etiology, are discussed.
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Affiliation(s)
- G Pulverer
- Institute for Medical Microbiology and Hygiene, University of Cologne, Germany
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Knöner W, Schultheiss D. [James Israel (1848-1926). His contribution to oral and maxillofacial surgery]. MUND-, KIEFER- UND GESICHTSCHIRURGIE : MKG 2003; 7:146-50. [PMID: 12764680 DOI: 10.1007/s10006-003-0467-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
The Berlin surgeon James Israel (1848-1926) is generally known as one of the leading kidney surgeons of his time. Furthermore, he is commemorated for describing actinomycosis bacteria, named after him in 1878: Actinomyces israelii. It is less well known that he also made several important contributions to maxillofacial surgery. This special aspect as well as Israel's biography is presented in this article from the history of medicine.
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Affiliation(s)
- Michael W Felz
- Department of Family Medicine, Medical College of Georgia, Augusta, GA 30912, USA
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Abstract
Abdominal actinomycosis is a rare condition that may mimic malignant disease. The authors report a case of adrenal actinomycosis discovered incidentally by computed tomography scan of the abdomen. Frozen sections and culture of the mass were consistent with actinomycosis. The diagnosis and management of actinomycosis is discussed in detail.
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Affiliation(s)
- Devdas Wali
- Department of Pediatric Surgery, State University of New York Downstate Medical Center, Brooklyn, NY, USA
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de Feiter PW, Soeters PB. Gastrointestinal actinomycosis: an unusual presentation with obstructive uropathy: report of a case and review of the literature. Dis Colon Rectum 2001; 44:1521-5. [PMID: 11598484 DOI: 10.1007/bf02234610] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A 55-year-old female patient is described who had recurrent retroperitoneal infections without an apparent focus. After a protracted period of illness the infection proved to be caused by actinomycosis. An unusual feature of the inflammatory process consisted of obstruction of the ureters, ultimately resulting in destruction of the left kidney. Hydronephrosis resulting from inflammatory fibrosis has not been reported in the literature before.
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Affiliation(s)
- P W de Feiter
- Department of Surgery, Division of Gastrointestinal Surgery, University Hospital Maastricht, Maastricht, the Netherlands
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Abstract
OBJECTIVE To examine the association between the use of intra uterine device (IUD) and the risk of actinomycosis in postmenopausal women. METHODS We report a case of pelvic actinomycosis in a postmenopausal woman who was wearing an IUD for 14 years until 20 months after the beginning of menopause. In the last 5 years the patient had been suffering occasionally from pain, abdominal tension and rectal tenesmus. The disease was revealed clearly 18 months after removing the intrauterine device. RESULTS The diagnosis of pelvic actinomycosis was only possible after hysterectomy, bilateral oophorectomy and multiple biopsies. At histological features a focus with actynomycetes colonies was evident. CONCLUSIONS This study supports the previously reported association between the pelvic location of actinomycosis and the use of the IUD. The removal of IUD should be mandatory in postmenopausal women.
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Affiliation(s)
- L Cobellis
- Chair of Obstetrics and Gynecology, Second University of Naples, via Santa Lucia n.39, 80132 Naples, Italy.
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Affiliation(s)
- B Schucher
- Departments of Internal Medicine, Municipal Clinic of Lüneburg, Lüneburg, Germany
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Nagler RM, Ben-Arieh Y, Laufer D. Case report of regional alveolar bone actinomycosis: a juvenile periodontitis-like lesion. J Periodontol 2000; 71:825-9. [PMID: 10872966 DOI: 10.1902/jop.2000.71.5.825] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cervicofacial actinomycosis infection most often involves the mandibular bone and rarely the alveolar crest. METHODS We describe a 14-year-old patient who had actinomycosis involving the alveolar bone at the left lower dental quadrant region. Resembling juvenile periodontitis, it was difficult to diagnose properly and resulted in devastating dental and periodontal consequences: loss of one tooth with most of its adjacent regional alveolar bone, severely compromising the support of two other teeth. RESULTS With the diagnosis came successful treatment, including surgical removal of the soft and hard tissues with concomitant prolonged penicillin administration. CONCLUSIONS We feel that this case should raise the interest and concern of both the periodontist and the general practitioner so that early diagnosis can be obtained, significantly improving the clinical outcome.
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Affiliation(s)
- R M Nagler
- Department of Oral and Maxillofacial Surgery, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa
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Pérez García MD, Rodríguez Alonso A, Núñez López A, Ojea Calvo A, Alonso Rodrigo A, Rodríguez Iglesias B, Barros Rodríguez M, Benavente Delgado J, González-Carreró Fojón J, Nogueira March JL. [Abdominal-pelvic actinomycosis with urinary tract involvement, secondary to gynecologic infection caused by intrauterine device]. Actas Urol Esp 2000; 24:197-201. [PMID: 10829454 DOI: 10.1016/s0210-4806(00)72430-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abdomino-pelvic actinomycosis is a condition caused by Actinomyces israelii, a Gram-positive opportunistic bacteria that triggers and develops the infection only in previously injured tissues, and then slowly progresses and spreads until it extrinsically affects the urinary tract. Use of an intrauterine device is a known risk factor to suffer from this disease. Relative risk in IUD users is two- to four-fold higher compared to IUD non-users. Risk increased with prolonged IUD use. Treatment is by removal of the causative agent, surgical resection of necrotic tissues and administration of intravenous Penicillin G, 4 million units every 4 hours for 30 days, followed by Amoxicillin 500 mg every 8 hours for 12 months. This paper contributes two cases of abdomino-pelvic actinomycosis with urinary tract involvement in IUD users. Standard treatment was employed with good evolution.
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Abstract
A review of the literature on pelvic actinomycosis reveals that actinomycetes normally reside in the female genital tract. Therefore the identification of actinomycetes in the vagina or cervix by any laboratory technique, including Papanicolaou smears with specific immunofluorescence or culture, is not diagnostic of any disease and is not predictive of any disease. The evidence strongly suggests that removal of the intrauterine contraceptive device of a patient with a positive culture is not necessary and that, in the absence of evidence for pelvic infection, antibiotics are not required. Pelvic actinomycosis is a rare disease whose pathogenesis is poorly understood.
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Affiliation(s)
- J Lippes
- Department of Gynecology and Obstetrics, School of Medicine, State University of New York at Buffalo, USA
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Nagler R, Peled M, Laufer D. Cervicofacial actinomycosis: a diagnostic challenge. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1997; 83:652-6. [PMID: 9195617 DOI: 10.1016/s1079-2104(97)90313-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Actinomycosis was first described as a clinical entity over 100 years ago. However, the fundamental characteristics of this entity have not been fully discussed, and major questions remain unanswered, such as the highly diversified pathogenicity of the phenomenon according to numerous published case reports and clarification of solid diagnostic criteria. Even the frequency of cervicofacial actinomycosis occurrence is unclear; some authors consider it to be rare and others to be common. We present 11 cases examined and treated in our department within the last 14 years along with a review of the literature. Diagnostic problems are emphasized, and a comprehensive overview of the entity is suggested.
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Affiliation(s)
- R Nagler
- Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Haifa, Israel
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Luckas MJ, Cawdell GM. Actinomycosis infection of a dermoid cyst mimicking pelvic malignancy. Aust N Z J Obstet Gynaecol 1995; 35:225-6. [PMID: 7677701 DOI: 10.1111/j.1479-828x.1995.tb01882.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- M J Luckas
- Maternity and Gynaecology Unit, Whiston Hospital, Merseyside, Liverpool, United Kingdom
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