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PubMed1999

Pelvic actinomycosis.

Pelvic actinomycosis is a rare chronic infection caused by bacteria of the family Actinomycetaceae. Prolonged use of an intrauterine contraceptive device (IUD) is a well known risk factor. We report six patients with pelvic actinomycosis, all of whom had an IUD inserted for over six years. Diagnostic problems necessitated a laparotomy in all patients. The pathohistological diagnosis was based on the characteristic microscopic image and specific staining. The patients were treated with penicillin and amoxycillin for several months.

Actinomycosis↗
PubMed1999

Splenic actinomycosis.

We report a rare case of abdominal actinomycosis occurring in the spleen and review the literature on abdominal actinomycosis.

Actinomycosis↗
PubMed1999

[Abdominal actinomycosis presenting as a malignant tumor--report of a case and review of the literature].

Actinomyces israelii is a normal inhabitant in the gastrointestinal tract of humans, it rarely causes disease. Abdominal involvement occurs in only 20 percent of all cases and can mimic malignant diseases, tuberculosis and inflammatory bowel disease. A case of a 36 years old female patient with abdominal actinomycosis and review of the literature is reported. Symptoms was presented as an acute abdomen associated with painful epigastric and left subcostal mass. The pathologic process infiltrated the retroperitoneal space simulated sarcoma or lymphoma. Diagnosis was established only at the second laparotomy, when histologic examination of the removed lymph node disclosed actinomycosis. The patient is completely free of symptoms 6 month after the second operation.

Abdomen↗
PubMed2000

[How fine needle aspiration biopsy make it possible to avoid extensive surgery. A case of abdominopelvic actinomycosis].

A case of abdominopelvic actinomycosis diagnosed by fine needle aspiration biopsy is reported. The patient, using an intrauterine device for five years, had a pelvic mass infiltrating the left ovary and five hepatic masses. Cytological smears prepared from an ultrasound-guided fine needle aspiration biopsy of one of the hepatic masses, showed actinomycotic granule. In the literature, few cases of abdominopelvic actinomycosis diagnosed by fine needle aspiration biopsy are reported. This affection, able to simulate a neoplasia on clinical and radiological grounds, is usually diagnosed on the histology of the surgical specimen. Ultrasound and computerized tomography allows to guide fine needle into necrotic areas where the probability to meet actinomycotic granules is maximum and so to avoid an extensive surgery.

Actinomycosis↗
PubMedDate not supplied

[Lingual actinomycosis: diagnostic problems. Review of the literature].

Actinomycosis of the cervicofacial area is a rare infection with a difficult clinical diagnosis. We report a case of lingual actinomycosis which was diagnosed after a long remission with empirical antibiotic treatment, two years after onset. The clinical characteristics, differential diagnosis, and therapeutic options in this unusual infection are discussed.

Actinomycosis↗
PubMed2000

[Pulmonary actinomycosis presenting as a mass lesion on chest X-ray film].

A 61-year-old man presented with fever, productive cough, and occasional blood-streaked sputum. Chest X-ray films disclosed a poorly defined mass in the right middle lung field. A transbronchial lung biopsy specimen showed epithelial changes indicative of lung cancer, and a right lower lobectomy was performed. Because the resected specimen contained a cavity filled with colonies of actinomycetes, pulmonary actinomycosis was diagnosed. The cavity was surrounded by inflammatory infiltrations and fibrosis with occasional atypical epithelial changes suggestive of benign hyperplasia. Although pulmonary actinomycosis is uncommon today, it deserves attention because of the potential difficulty in differentially diagnosing it from lung cancer.

Actinomycosis↗
PubMed1975

[Cerebral actinomycosis. Anatomo-clinical case report and review of the Brazilian literature].

A case of central nervous system actinomycosis is reported. A 33-year-old male complained of headache, vomiting and blurred vision lasting for eight days prior to admission. On examination, a right hemiparesis, as well an intracranial hypertension were detected. The cerebrospinal fluid showed mild lymphomononuclear hypercytosis. Necropsy disclosed three abscess in the cerebral hemispheres, in addition to moderate cerebral edema on the left side but without purulent leptomeningitis. Actinomyces filaments and granules were demonstrated in the cerebral and lung abscessess. The Brazilian literature on actinomycosis is reviewed and six published cases with nervous system involvement were found. Relevant clinical and anatomical aspects of the cases and of the present one are discussed.

Actinomycosis↗
PubMed2001

[Abdominal actinomycosis. Report of 4 clinical cases studied with radiography].

We report 4 cases of pathologically proven abdominal actinomycosis. US and CT demonstrated an infiltrative abdominal mass with ill-defined margins and heterogeneous enhancement after IV contrast. The ileo-cecal region was involved in one case; the mass appeared following cholecystectomy and recurred 3 years after surgical resection in one case; and no predisposing factor was identified in the 2 other cases. In one of these, recurrence was observed 12 years after the first episode. Actinomycosis must be included in the differential diagnosis of invasive abdominal lesions with "malignant" appearance.

Abdomen↗
PubMed2000

Pediatric cervicofacial actinomycosis: a case report.

Cervicofacial actinomycosis in children is a rare disorder. This article reports a case in a 7-year-old-girl. The importance of cervicofacial actinomycosis in the differential diagnosis of cervical masses in young patients is emphasized.

Actinomycosis, Cervicofacial↗
PubMed2001

[Primary actinomycosis of the abdominal wall. Description of 2 cases and review of the literature].

We report two cases of isolated abdominal wall actinomycosis and review 18 previously reported cases to further characterize the clinical findings and the therapeutic management of this syndrome. This diagnosis would be advocated in patients with a palpable abdominal mass of subacute appearance with a previous history of digestive medical illness, diabetes, abdominal surgery, or prolonged IUD use. In contrast with other actinomycosis locations, remarkable data were a more elevated mean age of patients; a female predominance; a prevalent location of mass in abdominal lower left quadrant; and a shorter duration of symptomatology before to diagnosis. The CT is the first choice for imaging study and percutaneous needle aspiration would be recommended for definite diagnosis. The long-term antibiotic therapy, with or without percutaneous drainage, is the first treatment choice because is very effective and made unnecessary a more invasive surgical management. The prognosis is excellent with adequated treatment.

Abdominal Muscles↗
PubMed1975

67Gallium accumulation in hepatic actinomycosis.

A case of actinomycosis involving the liver is reported. The liver scan with 99mTcS colloid showed multiple areas of focal abnormalities. 67Gallium citrate liver scan showed these areas to concentrate intensely. This pattern of differential hepatic scintigraphy is seen in pyogenic abscesses as well as malignancy of the liver. Actinomycosis may mimic the clinical picture of a malignant neoplastic process, making the differential diagnosis of 67Ga-positive lesions of the liver more difficult.

Actinomycosis↗
PubMed2001

[Actinomycosis of the small intestine--an unusual cause of acute abdomen].

Actinomycosis is subacute or chronic disease manifested by a defined granulomatous inflammation with the development of infiltrates, abscesses and fistulae. A 35-year-old female patient was admitted and operated at the Second Surgical Clinic because of symptoms of diffuse peritonitis. Laparotomy revealed a duplicit tumour of the small intestine, an abscess of the abdominal wall in the left mesogastrium and pyoovarium bilaterale. 70 cm of the small intestine were resected, incision of the abscess and bilateral adnexotomy were performed. Histological examination revealed a suppurative, partly fibroproductive inflammation with an actinomycotic etiopathology. After antibiotic treatment the patient was discharged home, the gynaecologist removed an intrauterine device. Three months after the first operation the patient in a serious septic condition was readmitted to the clinic with signs of diffuse peritonitis. A double perforation of the small intestine was found and an end-to-end anastomosis was made after resection of the small intestine. The postoperative course was complicated by respiratory failure and failure of the circulation associated with septic shock and subsequent death. In the conclusion the authors emphasize the problem of preoperative diagnosis of the abdominal form of actinomycosis, its possible development in relation to intrauterine contraceptive devices and its clinical manifestation as acute abdomen.

Abdomen, Acute↗
PubMed2001

[Colonic actinomycosis. Clinical, endoscopic and histological aspects in one patient].

Colonic location of actinomycosis must be distinguished from infected colonic carcinoma and other colonic inflammatory pseudotumors. The diagnosis is often made by histological examination of the tumor. Initial treatment consists in surgery, followed by an antibiotic treatment. We report the case of a 32-year old woman with a right colonic actinomycosis.

Actinomycosis↗
PubMedDate not supplied

Mesenteric actinomycosis with retroperitoneal involvement.

Mesenteric or retroperitoneal actinomycosis is an extremely rare disease. The international databases have revealed only 10 cases affecting the mesenterium and another 52 cases affecting the retroperitoneum. We report a 78-year-old female who was admitted with complaints of abdominal pain. Laboratory examination revealed anemia and the clinical examination revealed an irregular mass in the abdomen. Ultrasound and computed tomography (CT) scans showed a solid mass in the mesenteric-retroperitoneal region. Biopsy of the nonresectable mass revealed the presence of chronic inflammation in the mesenteric area with Actinomyces colonies. The patient was treated with oral amoxicillin, 500 mg every 6 hours for 6 months. The symptoms disappeared, but the mesenteric-retroperitoneal mass remains, but smaller in size. Based on the review of the literature and the case reported here, we conclude that mesenteric-retroperitoneal actinomycosis is difficult to diagnose by means of noninvasive techniques as it can masquerade as a malignant process. An accurate diagnosis is always obtained in a histological or microbiological examination, often requiring surgical intervention. Treatment with penicillin has proven to be effective.

Actinomycosis↗
PubMedDate not supplied

Esophageal actinomycosis in a patient with AIDS.

Actinomycosis has been rarely reported in patients with HIV/AIDS in contrast to other opportunistic and common pathogens. We report a case of esophageal ulcer disease, secondary to actinomycosis occurring in a patient with recurrent odynophagia. The diagnosis was made histologically only after repeated upper endoscopy with biopsies.

AIDS-Related Opportunistic Infections↗
PubMed2001

Cervicofacial actinomycosis--an issue still present.

On the basis of the literature the authors present the etiopathogenesis, entry of the infection and the course of cervicofacial actinomycosis and they describe treatment possibility of patients with actinomycosis. They also concentrate on the present, atypical clinical picture of the disease, especially in the initial period. They find the sanation of the oral cavity is necessary for a complete recovery.

Actinomycosis, Cervicofacial↗
PubMed1975

Untraditional glucose fermenting actinomycetes as human pathogens. Part II: Rothia dentocariosa as a cause of abdominal actinomycosis and a pathogen for mice.

Rothia dentocariosa was proved as a primary pathogen for man in the case of abdominal infection of a 19 year old woman. Clinical findings were typical for actinomycosis and the patient was cured with penicillin following surgery. Actinomycotic granules were proved by direct microscopy in the pus and R. dentocariosa was recovered as a single pathogen according to the microscopy. Two morphologically distinct isolates recovered from primocultures were described. They were studied separately and finally they were recognized as physiologically identical varieties of a single organism. In addition, the two morphological varieties of R. dentocariosa were considered to represent a particular kind of variability of the A-N type. The isolated germ was found to be pathogen for mice. Intraperitoneal infections provoked multiple nodules formation which were grown into the internal organs of experimental animals. The nodules were encapsulated and tended to spread without regard to the natural tissue plan. They contained pus involving microgranules of viable germs. This first report of the natural human infection caused by R. dentocariosa is the precedent for the definite establishing of this aerobic glucose fermenting actinomycete amidst the untraditional potential pathogens of human actinomycosis.

Actinomycetaceae↗