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PubMed1993

Actinomycosis of the retroperitoneum and an extremity: CT features.

A patient presenting with thigh and flank masses and back pain for 3 months proved to have actinomycosis involving the retroperitoneum and quadriceps muscle. Retroperitoneal involvement without intraperitoneal disease is rare. Computed tomography (CT), however, showed disease transgressing adjacent anatomic compartments with direct extension through the body wall and involvement of adjacent bony structures which is characteristic of actinomycosis.

Abscess↗
PubMed1988

Abdominopelvic actinomycosis associated with intrauterine devices. Two case reports.

Two case reports of abdominopelvic actinomycosis associated with an intrauterine device (IUD) are presented. In the first case, the association was difficult to establish and in the second one, a pelvic malignancy was suspected. The diagnosis and treatment of IUD-associated abdominopelvic actinomycosis are discussed on the basis of the present cases and the literature.

Actinomycosis↗
PubMed1982

Coincidental occurrence of actinomycosis and Ewing's sarcoma in a child.

Pulmonary consolidation, rarefaction of adjacent ribs and pleural effusion, a triad frequently considered characteristic of actinomycosis, seemed in the present case to support this serologically entertained diagnosis. However, the subsequent course of disease disclosed the most uncommon association of actinomycosis an metastatic Ewing's sarcoma of the lung. The possibility of combined occurrence of an opportunistic infection by actinomyces and malignancy, calls for open biopsy in cases not responding to penicillin treatment or with an unexpected evolution of the clinical manifestations.

Actinomycosis↗
PubMed1979

Pulmonary actinomycosis in children.

The radiological features of three cases of pulmonary actinomycosis in children are presented. Two of the cases had the classical roentgen features of chronic consolidation with overlying rib periostitis. The third had non specific consolidation but demonstrated extension through the diaphragm. Two of our cases were mentally subnormal children in institutional care. Their pulmonary pathology is almost certainly attributal to poor dental hygiene, a constant problem in this group of children. Hence, although pulmonary actinomycosis is rare in the general populus, we suggest it might be suspected more often in the subnormal group when chronic consolidation is present.

Actinomycosis↗
PubMed1994

Pelvic actinomycosis presenting with a rectal stricture: report of a case.

We present herein the case of a patient with actinomycosis involving the pelvic cavity, who presented with a rectal stricture. It is rare for this type of actinomycosis to be accurately diagnosed preoperatively, but a precise diagnosis, made using needle biopsy guided by computed tomography allowed for successful treatment by resection of the granulation tissue surrounding the rectal stricture through a transsacral approach.

Actinomycosis↗
PubMed1992

Actinomycosis of the distal colon and rectum.

Actinomycosis of the colon has rarely been reported; two such cases are presented. A predisposing factor appears to be the presence of a pre-existing intrauterine device (IUD). This history was present in one case in which there was perisigmoid abscess, local extension, and fistulous tract or the anterior abdominal wall. A second patient had anorectal involvement which resembled Crohn's disease, and was found to be HIV positive. There was mucosal irregularity, wall thickening, reactive adenopathy, perirectal fascial thickening, and a sinus tract, which responded well to penicillin. It is unclear if there is an increased incidence of clinical actinomycosis in the HIV positive population, as it has not to our knowledge been previously reported.

Actinomycosis↗
PubMed1989

Actinomycosis of the greater omentum.

A case of histologically proven actinomycosis of the greater omentum is reported. Computed tomography (CT) showed a mass at the greater omentum near the left flank area; it was hypervascular on angiograms and was supplied by the omental artery originating from the splenic artery. Sonography showed that the echogenecity of the lesion was complex. Actinomycosis of the greater omentum, although rare, should be included in the differential diagnosis of omental mass.

Actinomycosis↗
PubMed1989

Hepatic actinomycosis with portal vein occlusion.

Hepatic actinomycosis with abdominal wall invasion was found by computed tomography (CT) in a 44-year-old woman. Occlusion of the main and right portal veins by the actinomycoma causing cavernous transformation was proven by angiography. Duodenobiliary reflux and communication between the biliary tree and the abscess were demonstrated by upper gastrointestinal radiography, percutaneous transhepatic cholangiogram, and CT. The imaging studies reflected the pathologic process of this disease. The unique feature of this case is that infection ascended through the duodenobiliary reflux; this should be considered one of the routes for the transmission of hepatic actinomycosis.

Actinomycosis↗
PubMed1993

Multifocal thoracic actinomycosis simulating lymphoma.

Thoracic actinomycosis is rare in the pediatric age group. We report the unusual case of a 10-year-old girl who presented with prolonged fever and weight loss with a neck mass and multiple pulmonary nodules resembling lymphoma. Open lung biopsy confirmed the diagnosis of actinomycosis and the symptoms and signs improved after treatment with cephalosporin. The pathogenesis and radiographic manifestations are briefly discussed.

Actinomycosis↗
PubMed1996

Abdominal actinomycosis.

PURPOSE: Actinomyces israelii are normal inhabitants in the oral cavity and upper intestinal tract of humans. They rarely cause disease and are seldom reported as pathogens. As a pathogen it causes fistulas, sinuses, and may appear as an abdominal mass and/or abscess. The abdominal mass can masquerade as a malignant process that is very difficult to differentiate, often requiring surgical intervention with resection. Because of difficulty in making a preoperative diagnosis, we undertook this review to determine if all patients require surgical intervention and whether other adjunctive modalities may improve preoperative diagnosis. METHODS: We report two patients with abdominal actinomycosis, one affecting the sigmoid colon and the other the retroperitoneum, iliac crest region. Both simulated a malignant process and required operations for diagnosis and treatment. RESULTS: As reported, actinomycotic abdominal masses and strictures can be treated by penicillin alone. Long-term medical treatment seems to be very successful and avoids surgical resection. The difficulty is obtaining a definitive diagnosis. CONCLUSION: The computed tomographic scan is the most helpful diagnostic modality. Appearance of abdominal actinomycosis is usually a contrast enhancing multicystic lesion as was found in these two patients. Needle aspiration cytology can be fairly accurate in obtaining the diagnosis and is recommended for suspicious lesions.

Abdominal Abscess↗
PubMedDate not supplied

Abdominal actinomycosis: A complication of colonic perforation.

Actinomycosis is a chronic, suppurative, mycotic infection, which tends to form abscesses and fistulas. The organism is a saprophyte of the human mouth. When a break in the normal contiguity of the gastrointestinal tract occurs, the organism may gain access to the surrounding tissues and become almost impossible to eradicate without surgical extirpation and administration of a long course of antibiotics. The diagnosis of actinomycosis should be considered for any patient in whom persistent or unusual enterocutaneous fistulas develop, when there is a recent history of perforated viscus or surgical intervention involving the gastrointestinal tract, such as appendectomy. The diagnosis is confirmed by the presence of "sulfur granules" in the fistulous tracts.

Abdomen↗
PubMedDate not supplied

Esophageal actinomycosis.

Esophageal actinomycosis is uncommon and has been reported in immunocompetent and immunocompromised patients. A 41-y-old man with a history of heavy alcohol use presented with progressively worsening odynophagia and dysphagia over a 2-wk period. Upper gastrointestinal endoscopy and esophageal biopsy revealed ulceration with Actinomyces and candidal infection. After therapy with intravenous penicillin G followed by oral amoxicillin that led to clinical improvement, repeat upper gastrointestinal endoscopy revealed healing of esophageal ulceration and no evidence of Actinomyces. From this case and a review of the literature regarding clinical symptoms, diagnosis, and treatment, it is clear that esophageal actinomycosis is a cause of odynophagia and dysphagia. Upper gastrointestinal endoscopy and pathologic examination should be carefully evaluated in patients who present with odynophagia and dysphagia.

Actinomycosis↗
PubMed1997

Hepatic actinomycosis: case report and review of the literature in Japan.

Hepatic actinomycosis is rare. We report an 86-year-old Japanese man with a 3-day history of high fever and anorexia who had an actinomycotic liver abscess complicated by disseminated intravascular coagulation (DIC). A definitive diagnosis was made when an Actinomyces species was cultured from aspirated pus. The clinical course was satisfactory. Treatment included prompt percutaneous drainage coupled with long-term intravenous administration of high-dose minocycline and piperacillin, combined with therapy for DIC. We reviewed 11 cases in Japan of Actinomyces involving the liver, including the case reported here. In most patients, there were no predisposing factors. Common symptoms and laboratory findings included fever, abdominal pain, leukocytosis, and elevated C-reactive protein. In 6 of the 11 patients a partial hepatectomy was performed because hepatic tumor was suspected. Five patients presented with a liver abscess. Hepatic actinomycosis should be considered in the differential diagnoses of pyogenic liver abscess and space-occupying lesions of the liver.

Actinomyces↗
PubMed1998

[Cervical actinomycosis. A rare differential diagnosis of parotid tumor].

Actinomycosis is currently an uncommonly diagnosed human disease. However, it can still complicate trauma to the respiratory and digestive tracts, including operative procedures. A patient with cervicofacial actinomycosis commonly gives a history of recent dental manipulation which usually, involves extraction of a mandibular molar. The common initial symptoms of infection--such as, sudden onset of cervicofacial pain, swelling, erythema, edema and suppuration--can be absent. Infection due to actinomyces is a well-known mimic of malignancy is clinical, radiological and pathological findings. In the case described a 65-year-old man had a mass in his right parotid area. Because of its painless rapid growth with infiltration of the mandible as demonstrated by clinical findings and CT and MRI scans, we established an initial diagnosis of salivary gland malignancy. Salivary gland biopsy then revealed a histological picture of infection due to actinomyces. Therapy was initiated with intravenous amoxicillin and sulbactam. After 20 days of treatment diseased soft tissues and bone were resected. To prevent a relapse the patient received oral clindamycin for 6 weeks. After a followup of two years, the patient has remained free of disease.

Actinomycosis, Cervicofacial↗
PubMed2003

Esophageal actinomycosis: a case report and review of the literature.

A 37-year-old African-American male with acquired immunodeficiency syndrome (AIDS) presented with recurrent chest pain. An upper gastrointestinal endoscopy had been performed two months previously and esophageal biopsy revealed extensive candidal infection with ulceration. He temporarily responded to fluconazole. Repeat biopsy revealed actinomyces and continued candidal infection. Review of the original biopsy also demonstrated actinomyces in addition to candida. After initial response to therapy with penicillin, he worsened on outpatient therapy and subsequently expired from progression of disease. Lack of compliance may have been contributary. To date, 8 patients with esophageal actinomycosis have been reported, five of whom had AIDS. Of the remaining three, none was otherwise immunocompromised. This is the first report of esophageal actinomycosis occurring as a superinfection of candidal ulceration. We also describe the findings and utility of thoracic CT in this condition and review the literature.

Actinomycosis↗
PubMed2006

Computed tomographic demonstration of a fish bone in abdominal actinomycosis: report of a case.

A 53-year-old man who had the habit of consuming fish bones was referred to our clinic because of a suspected malignant abdominal wall tumor. Computed tomography (CT) showed a mass (10 x 5 cm) in continuity with the transverse abdominal muscle, containing a small calcification. A laparotomy was performed with a preoperative diagnosis of an inflammatory mass due to fish bone penetration from the sigmoid colon. A fish bone, measuring 2.3 cm in length, was detected within the tumor by specimen radiography. The pathological findings demonstrated actinomycotic colonies. We herein present the first case of a CT demonstration showing a fish bone in an abdominal mass which was pathologically confirmed to be actinomycosis. Evidence of the presence of a foreign body is valuable for diagnosing inflammatory nodules such as actinomycosis and differentiation from malignancies.

Abdominal Pain↗
PubMed1984

Intra-abdominal actinomycosis presenting with sulfur granules in the urine.

Intra-abdominal actinomycosis is rarely suspected and is difficult to diagnose. A 46-year-old woman with intra-abdominal actinomycosis is described in whom the condition was first suspected when sulfur granules were found in her urine. The infection had involved her bladder but not her kidneys.

Abdomen↗