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PubMed2003

An interesting case of primary cutaneous actinomycosis.

Actinomycosis is an infection commonly seen in tropical countries. It is characterized by chronic and progressive suppurative inflammation, typically presenting on the neck, thorax, and abdomen. Primary cutaneous actinomycosis is a rare entity, and the diagnosis requires a high index of clinical suspicion. Anaerobic cultures may be negative despite repeated attempts. Microscopic examination reveals the diagnosis in the majority of cases, and treatment requires administration of parenteral or oral penicillin for at least 6 weeks. We report a case of cutaneous actinomycosis affecting the arm. This patient was treated with phenoxymethylpenicillin.

Actinomycosis↗
PubMed2004

[Laryngeal actinomycosis].

Actinomycosis is a rare infectious disease in our practice and clinically it is charactherized by the presence of granulomatous lesions of subacute or chronic evolution. Most of the cases of actinomycosis are localised in the cervico-facial area, being the laryngeal one uncommon. We present a clinical case of a 53 years-old male diagnosed of primary laryngeal actinomycosis and we realise a bibliographic revision on this subject emphazising the diagnosis techniques and the differential diagnosis of this kind of lesions.

Actinomycosis↗
PubMed2004

[Tuboovaric actinomycosis. A report of a case].

OBJECTIVE: Tuboovaric actinomycosis case report. PRESENTATION PATIENT: eighteen-year-old woman using intrauterine devise for the past two years and with a four months old appendicectomy. Initially, a two month old pelvic tumor with acute abdominal pain and fever was identified. A laparotomy was performed with total pelvic tumor section. A week later, postoperatory colonskin fistula appeared requiring surgery. The histopathology report showed tuboovaric actinomycosis. Therefore, sodic penicillin was used to treat the patient until health was recovered. CONCLUSION: Actinomycosis is characterized by late diagnosis and must be suspected in patients with pelvic tumor exeresis with nonsatisfactory evolution, where intestinal surgery and IUD use are risk factors.

Abdominal Abscess↗
PubMed2004

Primary combined intra- and extra- abdominal actinomycosis. A case report.

Actinomycosis is an infrequent chronic progressive granulomatous and suppurative disease. This infection is caused by Actinomyces israelii, normally present in healthy individuals. We present a rare case of a combined intra- and extra- abdominal actinomycosis in a 50 year old female patient, with no underlying predisposing factors. The patient complained of a right lower quadrant pain. Although we first diagnosed a peri-appendiceal abscess, the CT scan suggested a right colon tumor. The patient underwent segmental colectomy and the histological examination of the specimen revealed colon actinomycosis. A review of the possible pathogenesis and therapeutic modalities is also presented.

Abdomen↗
PubMed2005

Periapical actinomycosis: a review.

Actinomycosis has increasingly been recognized as a cause of persistent or recurrent periapical disease associated with endodontically treated teeth. This case report shows the classic clinical picture of periapical actinomycosis: persistent periapical disease with recurrent sinus tracts. Although there was no pain or swelling after clinically acceptable initial endodontic treatment, a periapical lesion developed. After retreatment, the periapical lesion persisted, and a sinus tract developed. The sinus tract healed with antibiotic therapy but recurred within a few months. This cycle of sinus tract to antibiotic therapy to recurrence of the sinus tract repeated several times over a period of 5 years. Upon biopsy, periapical actinomycosis was diagnosed, where classic "sulfur granules" were demonstrated in the histologic examination of the periapical lesion. Antibiotic therapy for a period of 6 weeks was prescribed subsequent to the histologic diagnosis because of the possibility of spread of the actinomycotic infection into the maxillary sinus. Considerable healing was evident within 5 months of surgical and antibiotic treatment.

Actinomycosis, Cervicofacial↗
PubMedDate not supplied

[Abdominal actinomycosis: report of three cases].

We present three cases of abdominal actinomycosis in females, one presenting with an abdominal mass and the two others underwent emergency surgery because of acute abdomen with a diagnosis of complicated acute appendicitis. The first patient (age 36 years) presented with an abdominal mass in the left lower quadrant arising from the colon as observed by abdominal computed tomography (CT). The patient was brought to the operating room and tumoral resection was done. The second and third patients (37 years and 39 years, respectively) were brought to the emergency room because of acute abdominal pain with leucocytosis. Exploratory laparotomy was performed, finding in the second patient a bilateral ovarian abscess and uterine perforation. Hysterectomy and salpingo-oophorectomy were done. In the third patient, the findings were a sigmoid mass and a bilateral tubo-ovarian abscess and these organs were resected. Samples were sent for pathologic analysis. Microscopic analysis of the specimens sent revealed the presence of "sulfur granules," and a diagnosis of actinomycosis was made. Abdominal actinomycosis is a rare disease and preoperative diagnosis is uncommon. It is necessary to complete the full course of antibiotic therapy in order to completely eradicate the disease.

Abdomen↗
PubMed2005

[Fistula as a complication of pelvic actinomycosis--two case reports].

OBJECTIVE: The presentation of two unusual cases of pelvic actinomycosis. SUBJECT: Case reports. SETTINGS: Department of Obstetrics and Gynecology, Hospital Kladno. SUBJECT AND METHOD: The observation of two cases of pelvic actinomycosis. These cases were complicated by the abdominal wall fistula in one case and vaginal fistula in the other. CONCLUSION: Actinomycosis is a chronic disease with tendency to progress per continuitatem into neighbouring tissues and with tendency to formation of fistulas. Two less common localisations of progress of the disease are described; it means the abdominal wall and vagina. In spite of a more advanced stadium, if adequately treated, a recovery ad integrum is common.

Abdominal Wall↗
PubMed2005

[Actinomycosis of the middle ear: case report].

INTRODUCTION: Actinomycosis of the middle ear are rare and often atypical and remain ignored for a long time. This delayed the diagnosis and obscured the forecast of the disease. AIM OF STUDY: Our objective is to give a progress report on this affection in the light of a new observation and data of the literature. CLINICAL CASE: 58 year old patient who consults of a left chronic otitis media with a posterior perforation. A CT scan had shown a filling of the middle ear in favour of a cholesteatoma. A tympano-mastoidectomy was realized and the histological examination of the product of excision had sowed that it acts of an actinomycosis of the middle ear. The treatment consisted of penicillin for 5 months. The continuations are good after 14 months of follow-up. CONCLUSION: The actinomycosis of the middle ear must be known to evoke the diagnosis in various clinical circumstances. Its diagnosis makes it possible to adopt an adapted and non aggressive therapeutic attitude, avoiding heavy surgical gestures, sources of complications or after-effects. The antibiotherapy containing penicillin is the essential element, either separately, or in complement of gestures of surgical drainage.

Actinomycosis↗
PubMed2005

Pulmonary actinomycosis mimicking chest wall tumor in a child.

Actinomycosis is an uncommon disease in children and most cases are cervicofacial infections. To date, there have been only a few reports on children with chest wall involvement due to actinomycosis. Here we report a 9-year-old girl with a mass lesion in the chest wall mimicking Ewing's sarcoma of the rib. Thoracic actinomycosis without typical features of the disease is often evaluated with the suspicion of neoplasia. This rare entity should be considered in the differential diagnosis of mass lesions of the chest wall in children. The disease responds well to penicillin treatment.

Actinomyces↗
PubMed2005

Abdominal actinomycosis complicated with hydronephrosis.

Actinomycosis is a chronic supportive granulomatosis disease caused by the anaerobic Gram-positive organism Actinomyces. We report a 16-year-old boy with abdominal actinomycosis who presented with a 2-week history of intermittent abdominal pain. He complained of oliguria during the 3 days prior to admission. Abdominal computed tomography revealed a large inflammatory mass obstructing the ureter, which led to hydronephrosis of the right kidney. Exploratory laparotomy was performed and actinomycosis was confirmed by the presence of sulfur granules and filamentous bacteria. Postoperatively, the patient was successfully treated with long-term penicillin and recovered completely.

Abdominal Pain↗
PubMed2005

Actinomycosis: a rare soft tissue infection.

Actinomycosis is a chronic and suppurative infection caused by an endogenous Gram-positive bacterium. The usual sites of infection are the head and neck, thorax, and abdomen. Primary cutaneous actinomycosis is very rare and usually associated with external trauma and local ischemia. We report on the case of a primary cutaneous actinomycosis of the thigh in a 34-year-old man. The patient was treated successfully with surgical resection and combined antibiotic therapy, and eventually cutaneous reconstructive surgical procedure.

Actinomycosis↗
PubMed1992

Endoscopic detection and therapy of colonic actinomycosis.

Abdominal actinomycosis is a disease that is difficult to diagnose nonoperatively. Usual manifestations are abscesses and draining sinus tracts. Treatment is typically surgical and requires prolonged intravenous antibiotics. Presented is a patient who underwent surveillance colonoscopy after resection for colon carcinoma. Diagnosis of colonic actinomycosis and subsequent resolution was demonstrated endoscopically after lengthy oral penicillin therapy (2 g/day for 1 yr). This case documents that resection may not be necessary to effect cure of abdominal actinomycosis.

Actinomycosis↗
PubMed2006

Pelvic actinomycosis: a case report.

BACKGROUND: Pelvic actinomycosis is rare but can manifest with multiple presentations. CASE: A 28-year-old woman, gravida 4, para 2, conceived with a Paraguard intrauterine device (IUD) (FEI Products LLC, North Tonawanda, New York) in place. The IUD had been present for 2 years. The patient presented with an incomplete abortion at 6 weeks' gestation, and the IUD was removed. Two and one-half months later the patient presented with signs and symptoms of pelvic inflammatory disease and underwent hospitalization and exploratory laparotomy. The pathology specimen revealed diffuse actinomycosis involving the tube and ovary, appendix, and bowel mucosa. A Pap smear 3 months earlier had revealed Actinomyces. CONCLUSION: Actinomyces has been associated with IUD use and may present even after removal of the IUD. Pelvic actinomycosis is rare, and removal of the IUD may not be adequate treatment. If a patient presents with symptoms of infection, early diagnosis and aggressive antibiotics may prevent further complications.

Abortion, Incomplete↗
PubMed1991

Thoracic actinomycosis--review of 9 cases.

Nine cases of thoracic actinomycosis treated in the period from 1976 to 1990 were reviewed. Among them, 4 cases were children. The clinical symptoms and laboratory examinations were non-specific. Chest roentgenographic manifestations including nodular (3 cases), infiltrations (4 cases), and infiltrations with pleural changes (2 cases) were also non-specific. Chest wall masses were noted in four patients. There were no cases correctly diagnosed on admission. The diagnosis of thoracic actinomycosis was made from thoracotomy in 6 cases, from culture of chest wall mass incisional specimens in 2 cases and from bronchoscopic biopsy in 1. All the patients received antibiotics, however the varied duration of postoperative antibiotics did not change the outcome. No mortality or recurrence was noted in our 9 patients with a mean follow-up of 1.9 years (from 2 months to 6 years.) We conclude that surgical intervention is still the cardinal method for diagnosis and treatment. Establishment of the role of postoperative antibiotics will need further prospective study. The prognosis of thoracic actinomycosis is fairly good.

Actinomycosis↗
PubMed1990

Pelvic actinomycosis associated with intrauterine contraceptive devices--a review of 6 cases.

We analysed the clinicopathologic aspects of 6 cases of pelvic actinomycosis associated with intrauterine contraceptive devices seen and treated at Mackay Memorial Hospital between 1987 and 1989. All of them had IUD for a period from 5 to 20 years. The incidence of pelvic actinomycosis among all our gynecological admission number during the same period was 0.08%. The most frequent presenting symptoms were lower abdominal pain and abnormal vaginal bleeding. An abdominal total hysterectomy with a bilateral or unilateral salpingoophorectomy was performed on all 6 cases due to a tubo-ovarian abscess or a pelvic mass. We do not find any relation between the presence of pelvic actinomycosis and the type of IUD. However, the study number was too small to make a definitive statement, but the length of time of IUD insertion is of greater significance.

Actinomycosis↗
PubMed1990

[Foreign body-induced bronchial actinomycosis with severe stenosis that must be distinguished from lung cancer].

A 59-year-old woman who accidentally swallowed a foreign body (fish bone) 9 months ago was admitted to our hospital because of cough, hemosputum and sleep wheezing for two months. Chest roentgenograms and chest CT scanning revealed severe stenosis of the right lower lobe bronchus and truncus intermedius, suggesting lung cancer. Bronchoscopic examination revealed an intrabronchial foreign body. The biopsy specimen from granulation tissue revealed bronchial actinomycosis. The foreign body was removed bronchoscopically after an extensive chemotherapy with penicillin G (for actinomycosis) and prednisolone (for granulation tissue of the bronchus). This was considered to be a rare case of bronchial actinomycosis without a pulmonary lesion produced by a foreign body.

Actinomycosis↗
PubMed1990

Cervicofacial actinomycosis in children.

Actinomycotic infections, once common in humans and cattle, are now rare causes of disease in man. This general group of organisms belongs taxonomically between the true bacteria and the fungi; however, the organisms behave clinically like true anaerobes. The organism, although phagocytized by the host cells, is not killed. Therefore, it is defined as a facultative intracellular parasite of the host. The protean manifestations of actinomycotic infections often mimic infectious processes, such as osteomyelitis or granulomatous disease, as well as neoplasia. It is therefore important for the surgeon to include actinomycosis in the differential diagnosis of cervicofacial masses in children as well as in adults. Being an anaerobe, the organism is difficult to culture and the diagnosis must be considered at the time of biopsy of a cervicofacial mass or when culturing a sinus tract. A case of a 12-year-old girl seen at Children's Hospital of Los Angeles prompted the review of our experience with this disease. In this child, actinomycosis presented as an expansile mass in the mandible. From 1956 to 1986, five children were treated for cervicofacial actinomycosis. Detailed case analysis, pathophysiology, clinical characteristics, and current treatment recommendations are presented.

Actinomyces↗
PubMedDate not supplied

[The bacterial associations in maxillofacial actinomycosis].

A variety of clinical forms of actinomycosis, difficulties of its early diagnosis and particularly of the differential diagnosis between this condition and tuberculosis, nocardiosis, aspergillosis necessitate the development of present-day methods for the early laboratory diagnosis of actinomycosis. Basing on the data on present-day methods for isolation of anaerobic and microaerobic diphtheroids, the authors characterize the bacterial associations occurring in maxillofacial actinomycosis and other odontogenic processes, discuss problems in isolation and identification of Actinomyces cultures.

Abscess↗