SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
We report a middle aged smoker with recurrent pneumonia caused by endobronchial actinomycosis secondary to a tooth aspiration. Unlike previously reported cases, our patient was not chronically debilitated. The case suggests that a follow-up bronchoscopy is beneficial after the initiation of antibiotic therapy for endobronchial actinomycosis.
Actinomycosis of spine is a very rare disease. Very few cases have been studied and reported in the past. The dilemma of distinguishing the condition from other disorders relies on the competency of the treating physician and a proper knowledge of the subtle radiological differences between these disorders especially in underdeveloped and developing countries where tuberculosis still has a very strong foothold. A rare atypical case of actinomycosis of spine resembling tuberculosis is presented.
A case of cervicofacial and pulmonary actinomycosis associated with non-Hodgkin's lymphoma (NHL) is reported. The patient underwent antimicrobial treatment and surgical debridement of a palatine lesion. Complete clinical recovery was achieved. The presence of actinomycosis may obscure and delay the diagnosis of NHL.
We present an unusual observation actinomycosis involving muscles of the back and probably of one thigh in a patient with pulmonary lesions. The patient was alcoholic and a heavy smoker and his teeth were in very poor repair. Opportunity is taken to review the literature on the rare cases of muscular actinomycosis.
We report the case of a 38-year-old woman who had pulmonary actinomycosis that involved the pleura and the pectoral muscles. The patient was initially treated with intravenous ceftriaxone once a day on an outpatient basis. After 3 weeks of treatment, a computed tomogram showed resolution of the initial findings. This result suggests that ceftriaxone may be an effective and convenient therapeutic agent for the initial parenteral treatment of actinomycosis.
Actinomyces species are rare but treatable causes of CNS infection. Differentiation of actinomycosis from nocardiosis is crucial to the selection of appropriate antimicrobial therapy. A review of 70 cases of CNS actinomycosis was conducted in an effort to characterize clinicopathologic features and identify patients with a high risk of death from infection. Types of lesions included brain abscess (67%), meningitis or meningoencephalitis (13%), actinomycoma (7%), subdural empyema (6%), and epidural abscess (6%). Most infections developed from distant sites (lung, 19 cases; abdomen, four; pelvis, three) or contiguous foci (ear, sinus, and cervicofacial region, 21 cases). For nonmeningitic infection, signs and symptoms were generally those of a space-occupying lesion and were indistinguishable from the manifestations of other pyogenic infections except for a longer interval before diagnosis. Risk factors included dental caries; dental infection; recent tooth extraction; head trauma; gastrointestinal tract surgery; chronic otitis, mastoiditis, or sinusitis; chronic osteomyelitis; tetralogy of Fallot; and actinomyces infection of an intrauterine device. Optimal management combined adequate surgical drainage with prolonged antibiotic therapy (mean duration, 5 months). Overall mortality from treated infection was 28%; 54% of survivors had neurologic sequelae. Features correlated with a poor prognosis were disease onset greater than 2 months before diagnosis and treatment, no antibiotic treatment, no surgery, and needle aspiration drainage of abscess lesions.
Previous computed tomography reports of pulmonary actinomycosis most commonly describe single, unilateral parenchymal or pleural masses with or without cavitation. The authors describe a thoracic computed tomograph of histologically proven actinomycosis that revealed multiple, bilateral, small pulmonary parenchymal nodules with an associated liver mass, suggesting hematogenous dissemination to the lungs from the liver via the hepatic veins.
A case is reported in which a unilateral parotid gland cystadenolymphoma was combined with actinomycosis. A 48-year-old woman presented with a mass in the left parotid region and paresis of the lower left palpebra. The computed tomography, echography, and parotid radiographic findings did not exclude a neoplasm of the left parotid gland. The ramus of the mandible was involved in the process. Intraoperative freezing histology, total parotidectomy, and partial mandibulectomy were performed, with sacrifice of the facial nerve followed by nerve reconstruction. The final histological evaluation was Warthin tumor with actinomycosis. Four years after treatment, the patient is free of disease. No similar cases seem to have been reported thus far.
Actinomycosis is an unusual bacterial infection that most often affects the head and neck region. Abscesses occasionally associated with a draining sinus may result secondary to extensive tissue destruction. We report the CT appearance in a case of actinomycosis of the neck. A thick walled enhancing mass with a low attenuation center was identified between the sternocleidomastoid muscle and the strap muscles of the neck. Enhancement of the adjacent muscles was present. Surgery confirmed an abscess with inflammation of the adjacent muscle. Histologic examination of the specimen showed the presence of multiple yellow (sulfur) granules containing Actinomyces. Computed tomography correctly determined the extent of the mass and lack of involvement of the deep structures of the neck.
We have described two patients with abdominal actinomycosis, one with extensive intra-abdominal and thoracic disease mimicking metastatic carcinoma, and the other having the rarely described clinical entity of retroperitoneal disease without evidence of intra-abdominal involvement. Both patients responded well to appropriate therapy, but had unnecessary surgical procedures. The surgeon's role in cases of actinomycosis should be limited to the provision of a diagnosis when necessary.
Despite the impairments of cellular and humoral immunity that accompany the acquired immunodeficiency syndrome, there has not been increased evidence of thoracic actinomycosis. We report on a patient with the human immunodeficiency virus (HIV) infection who had pulmonary actinomycosis. We review the current ideas regarding this unusual pulmonary pathogen and offer possible explanations for its rare appearance in the HIV population.
Primary actinomycosis of the musculoskeletal system is an unusual occurrence. We report the case of a 14-year-old boy with isolated actinomycosis of the quadriceps. Surgical drainage followed by 6 weeks of treatment with oral tetracycline yielded a good result.
An uncommon situation of primary actinomycosis of the breast is reported in a 40-year-old woman who presented with a lump, clinically simulating malignancy, in the right breast. Diagnosis of actinomycosis was established by incision biopsy. Resolution of infection, while conserving the breast, was achieved by timely diagnosis, limited surgery, and effective antibiotic therapy. Diagnostic failures leading to avoidable mastectomies have not been uncommon in cases previously reported in the literature. It is, therefore, imperative that this condition be considered in the differential diagnosis of intractable breast abscess and malignancy.
Primary cutaneous actinomycosis is very uncommon because of the exclusively endogenous habitat of the organism. We report a case of primary cutaneous actinomycosis characterized by histopathological "sulfur granules". The patient had a well-defined subcutaneous nodule on the left thigh without any other lesion and was treated with surgical excision and subsequent oral ampicillin for six weeks. There has been no recurrence during a 1-year period of follow-up.
Primary cutaneous actinomycosis is rare and can mimic mycetoma, tuberculosis and nocardiosis. The results of cultures (aerobic and anaerobic) are not always positive. A high degree of clinical suspicion should be entertained and a combination regimen of penicillins with sulphonamides should be used for treatment. We report a patient with primary cutaneous actinomycosis over the buttock, who was successfully treated with amoxicillin and sulphonamides.
Actinomycosis of the anterior abdominal wall is a rare infection caused by different Actinomyces species. We report a case of primary actinomycosis localized on the anterior abdominal wall, diagnosed by computed tomography (CT) scan, postoperatively confirmed by histopathological examination and treated by surgical resection combined with postoperative antibiotic therapy. The patient has been free of recurrence after 1 year. A review of the available literature is also presented.
A 46-year-old woman presented with a hypogastric mass. The preoperative diagnosis was a malignant ovarian tumor involving multiple organs, including the urinary bladder. Surgical exploration was performed with wide resection of the right ovary and uterus, including the affected ileum, sigmoid colon, and omentum. An intraoperative histopathological examination of the paravesical tissue revealed abdominal actinomycosis. Consequently, bladder resection was not done. The cause of abdominal actinomycosis in this patient was probably due to implantation of an intrauterine device 3 years previously.
Actinomycosis is a rare granulomatous chronic infection that is localized most frequently in the cranio-cervical region. Renal localization is exceptional. The authors report a new case of pseudo-tumoral actinomycosis and discuss diagnostic and treatment issues of this disease.