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PubMed1990

[Abdominal actinomycosis in children].

A total of four children (1 female and 3 male subjects aged from 3.5 to 10 years) is reported as treated by surgery and antibiotics for the abdominal focus of actinomycosis. The infection was manifested as an infiltration around the inflamed appendix in one case, the second case was related with multiple infiltrations in the abdominal wall and pelvic region. Two patients showed cyst and eventually urachal sinus infiltrated with actinomycosis. The diagnosis was determined in all cases from histology. In three cases, the inflammatory tumor was exstirpated in toto. The treatment with penicillin combined with streptomycin or other antibiotic has lasted no longer than 6, 28, 29 and 80 days, respectively. The emphasis is made on the benefit of resectional surgery which reduces the amount of antibiotics needed and shortens the therapeutic course of actinomycosis.

Abdomen↗
PubMed1989

[Abdominal actinomycosis: review apropos of 3 cases].

Actinomycosis is a chronic bacterial infectious disease, characterized by multiple abscesses, draining sinuses and abundant dense fibrous tissue. The intra-abdominal variety is rarely found and difficult to diagnose. We report three cases of intra-abdominal actinomycosis successfully treated by surgery and by longterm antibiotic therapy. One patient had a liver actinomycosis and two had ileo-caecal disease. Pertinent literature is reviewed.

Actinomycosis↗
PubMed1989

Abdominal actinomycosis: evaluation by computed tomography.

Actinomycosis causes disease in multiple organ systems and involves the abdomen approximately 20% of the time. We report a case of a 48-yr-old woman with a large abdominal mass secondary to actinomycosis. The patient demonstrates the clinical and pathologic features of this disease, as well as the role of evaluation by barium examination and computed tomography (CT). A discussion of abdominal actinomycosis is included.

Actinomycosis↗
PubMed1989

[Thoracic actinomycosis].

Actinomycosis is an infectious disease distributed all over the world. Males are affected three times more than females; the incidence of the disease is higher in adults than in children. The main causative agent is Actinomyces israelii, which can be found in the oropharynx of healthy persons. Therefore actinomycosis represents always an endogenous infection, often in connection with other bacteriae. The thoracic manifestation amounts to approximately 15 percent of all cases. The main clinical symptoms are pain, fever, cough, fatigue, and weight loss. The blood picture shows an increased number of white blood cells with a left shift in the differential white blood cell count. Furthermore, there is a strongly raised erythrocyte sedimentation rate. Radiographs demonstrate no typical patterns of pulmonary abnormalities. For the diagnosis there is a need of anaerobic cultures, in second line histological examination of tissue specimens. Differential diagnosis of actinomycosis includes chronic pneumonias caused by other rare germs and neoplasms. After early onset antibiotic long term treatment a good prognosis may be expected. Penicillin represents the antibiotic of first choice.

Actinomycosis↗
PubMed1989

Primary cutaneous actinomycosis of the extremities: a report from Japan.

A 30-year-old man with cerebral palsy showed cutaneous actinomycosis of the extremities. The diagnosis was confirmed by the histopathologic finding of "sulfur granules." Actinomyces israelii was not cultured as is often the case with actinomycosis. The disease was successfully treated with piperacillin and then with minocycline. This is, to the author's knowledge, the first report in English on actinomycosis from Japan, and the rarity of its occurrence in the extremities is documented.

Actinomycosis↗
PubMed1988

[Manifestations of actinomycosis of the head and neck].

The clinical features of actinomycosis affecting the ear, nose and throat are presented. One patient with actinomycosis of the ear suffering from mastoiditis and a Bezold abscess is discussed in detail. The disease is rare: only 10 patients with actinomycosis of the tympanomastoid area have been described in the English literature. The diagnosis is therefore often delayed. Effective treatment requires combined surgery and long-term chemotherapy.

Abscess↗
PubMed1985

Actinomycosis. Surgical aspects.

Actinomycosis is an anaerobic infection caused by actinomycetes, which are part of the normal flora in the oral cavity and intestine. Antecedent disease or surgery predisposes to infection, and involved tissue becomes indurated and forms multiple draining fistulae discharging characteristic sulfur granules. Three principal clinical syndromes are described: cervicofacial, thoracic, and abdominal. Recently pelvic actinomycosis has become more prevalent and associated with women who use the intrauterine device. The diagnosis of actinomycosis usually is made at surgery. Biopsied material histologically demonstrates sulfur granules and filamentous gram-positive rods. The differential diagnosis includes cancer and other chronic infections. Treatment consists of appropriate antimicrobial therapy and often surgery including incision and drainage or excision of abscesses, drainage of empyemas, and removal of persistent sinuses.

Abdomen↗
PubMed1980

[Pulmonary actinomycosis grafted on former tuberculous lesions. Report of one case (author's transl)].

The occurrence of actinomycosis localized in former tuberculosis cavities in a 39-year-old woman is reported. Exeresis of the lesions allowed the discovery of Actinomyces israelii in one of the cavities which no longer communicated with the bronchial tree. In contrast to diffuse actinomycosis found in immuno-depressed patients, this form of the disease was localized in a woman in good health. A decrease of pulmonary defense mechanisms could be involved locally. The infrequency of a tuberculosis-actinomycosis sequence, contrary to aspergilloma, is perhaps due to the anaerobic metabolism of the Actinomyces.

Actinomyces↗
PubMed1981

Uterine actinomycosis. A case report and review.

Current literature documents an association between intra-uterine contraceptive usage and genital tract colonization or infection with actinomycosis. Uterine involvement, however, is extremely rate. A case of severe pelvic infection with uterine perforation due to an actinomycosis fistula as confirmed by tissue is presented. The condition of actinomycosis is reviewed with special attention to involvement of the female pelvic organs and the difficulties in diagnosis.

Actinomyces↗
PubMed1981

[Disseminated actinomycosis presenting with multiple subcutaneous abscesses (author's transl)].

The case report describes a patient hospitalized for multiple subcutaneous abscesses who presented a four-year history of recurrent skin lesions and a fifteen-year history of non specific bronchopulmonary infections requiring segmental resection. The diagnosis of actinomycosis, A. israeli species, was established by culture of surgical drainage material from a thoraco-abdominal wall abscess. Muscle and bone involvement of the right thigh was subsequently demonstrated. There was no evidence of pulmonary infection at the time of hospitalization. Treatment with Penicillin G was curative. A review of the literature is presented together with a summary of thirteen reported cases. Although disseminated actinomycosis has become very rare since the introduction of antibiotic therapy, patients share similar features and a common clinical pattern which are highly evocative of the disease. All patients described had preceding pleuropulmonary disease, characteristically chronic. Evolution of cutaneous lesions was subacute or chronic. In all cases, there was significant delay (months to years) between the initial appearance of skin lesions and subsequent diagnosis. In most cases, actinomycosis had not been suspected. Diagnosis was usually established by isolation and identification of the micro-organism in cultures of purulent material obtained from cutaneous lesions. Despite the probability of hematogenous disease dissemination, pleuro-pulmonary foci were only rarely demonstrated. Prolonged antibiotic therapy was curative in all treated cases.

Abscess↗
PubMed1980

Actinomycosis complicating Crohn's disease.

A case of secondary infection of Crohn's disease by Actinomyces is reported. Clinically, Crohn's disease and actinomycosis may be difficult to differentiate. The distinguishing histopathological features of secondary actinomycosis include multiloculated abscesses, sulfur granules, typical organisms seen with Gram stain, and rarely, necrotizing granulomata. As actinomycosis may be cured by surgery and/or antibiotics, a careful search for Actinomyces including anaerobic culture is recommended in Crohn's disease with abscess formation.

Abscess↗
PubMed1980

A histological and ultrastructural comparison of the sulfur granule of the actinomycosis and actinobacillosis.

The sulfur granules of actinomycosis and actinobacillosis were studied histologically and ultrastructurally. The sulfur granule of actinomycosis was large, and oval or horsehoe-shaped. In it, there were a number of gram-positive, filamentous or short rod-like hyphae beneath clubs. Ultrastructurally, the center of the sulfur granule was composed of a cluster of hyphae, and the periphery was surrounded by clubs arranged radially. The clubs were made of electron-dense fine granules and had a degenerated hypha at the center. These granules varied in amount from small to large. As for the host reaction, neutrophil infiltration appeared first around the sulfur granule. Then epithelioid cells proliferated and phagocytized hyphae. Finally, proliferating fibroblasts enclosed them and formed tiny granulomas. The sulfur granule of actinobacillosis was small and lobulated. In it, a number of gram-negative, short rod-like bacteria were present beneath clubs. Ultrastructurally, the center of the sulfur granule contained intact or degenerated bacteria, and the periphery was composed of radially projecting clubs. These clubs were made of electron-dense amorphous material, in which several layers of tubular structures surrounded the bacterium conentrically. The host reaction was almost the same as that of actinomycosis. The proliferation of fibroblasts was prominent. There was a strong tendency for these cells to form many tiny granulomas.

Actinobacillosis↗
PubMed1995

Hepatic actinomycosis: a case report.

A 64-year-old man with hepatic actinomycosis presented with several months of weight loss and poor appetite. However, no fever was noted before admission. Findings on abdominal sonography and computed tomography scan were suggestive of hepatocellular carcinoma. A sono-guided percutaneous liver biopsy specimen demonstrated only chronic fibrosing inflammation. Therefore, laparotomy was performed and the diagnosis of hepatic actinomycosis was established after surgical resection. The patient was then successfully treated. The fact that hepatic actinomycosis may be very similar to hepatocellular carcinoma should be highly suspected. The hospital course of this patient concerning this condition and a brief review of the literature are presented to illustrate the diagnostic difficulties which may be encountered in such cases.

Actinomycosis↗
PubMed1995

[Rare manifestation of actinomycosis as retroperitoneal space-occupying lesion].

Actinomycosis has to be included in the differential diagnosis of retroperitoneal masses especially when surrounding tissue is infiltrated. We present a 40 year old male patient with the rare manifestation of retroperitoneal actinomycosis. The definitive treatment consisted of surgical drainage and long-term penicillin therapy resulting in complete healing. Special features in clinical symptomatology and problems concerning diagnosis of actinomycosis are discussed.

Abscess↗
PubMed1995

[Pulmonary actinomycosis presenting as a mass shadow with a cavity on chest radiography].

A 53-year-old woman was admitted with diabetes mellitus. After admission, a tumor shadow was detected by chest radiography and blood was found in her sputum. Despite further investigations, no definite diagnosis was made. Pulmonary wedge resection was performed because malignancy could not be excluded. Histological examination of the resected lung specimen led to the diagnosis of pulmonary actinomycosis. In Japan, 59 cases of pulmonary actinomycosis were reported between 1964 and 1993. These reports indicate that many cases of this disease are diagnosed by histological examination of resected lung specimens. Pulmonary actinomycosis has become even rarer recently because of the development of chemotherapy. We report this case and discuss the relevant literature.

Actinomycosis↗
PubMed1995

Recognition of renal actinomycosis: nephrectomy can be avoided. Report of a case.

Nephrectomy is performed for the diagnosis and treatment of renal actinomycosis. A cachectic 62-year-old man with a left renal mass underwent exploration and needle biopsy of the mass. No malignant disease was found. When his condition further deteriorated, the kidney was re-explored. Numerous biopsies intraoperatively finally revealed actinomycosis, so the operation was terminated with preservation of the kidney. Long-term treatment with antibiotics was begun with immediate, marked improvement in the patient's condition. At 1 year the renal mass had almost resolved. This is the first reported case of the diagnosis and treatment of renal actinomycosis without nephrectomy.

Actinomycosis↗
PubMedDate not supplied

Pelvicobdominal actinomycosis associated with an intrauterine contraceptive device. A case of liver dissemination mimicking metastatic ovarian cancer.

A rare case of pelvicoabdominal actinomycosis with liver dissemination is reported in a patient with an intrauterine contraceptive device (IUCD) in place for 10 years. Her initial preoperative diagnosis of metastatic ovarian cancer emphasizes the slow indolent destructive nature of actinomycosis mimicking a malignancy. A history of an indwelling IUCD for several years along with a pelvic mass should prompt consideration of actinomycosis as a possible etiology.

Actinomycosis↗
PubMed1993

Actinomycosis of the accessory breast treated with cotrimoxazole.

Actinomycosis is a chronic suppurative granulomatous disease caused by the filamentous bacteria, Actinomyces israelii, which was once thought to be a fungus. It is a Gram-positive, aerobic or microaerophillic, non acid-fast hyphal organism which fragments into coccoid or bacillary forms and, unlike the fungus, does not form conidia. Accessory breast tissue usually occurs along the milk lines, frequently in the axilla and rarely in the thighs. Actinomycosis of the breast is very uncommon and we report the case of a multiparous woman who had a painful lump in the axilla which, on histopathologic examination, showed actinomycosis within the accessory breast tissue.

Actinomycosis↗