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At least 595 records · Page 33Linked to original sources
PubMed1999

Urinary undiversion for pelvic actinomycosis: a long-term follow up.

BACKGROUND: A 43-year-old woman who had been using intrauterine contraceptive devices for the past 10 years underwent an emergency operation for bowel and urinary obstruction. METHODS/RESULTS: Frozen section analysis showed undifferentiated adenocarcinoma. Incomplete tumorectomy, ileal resection, partial cystectomy, colostomy and bilateral ureterocutaneostomy were palliatively performed. Postoperatively, periodic acid-Schiff and Grocott-Gomori methenamine tests revealed Actinomyces and the final diagnosis was pelvic actinomycosis. Treatment with penicillin G administered intravenously relieved her symptoms and the lesion was dramatically improved. The patient underwent colostomy closure and urinary undiversion. CONCLUSIONS: Five years after urinary undiversion, the patient's renal function has been maintained and she can void without incontinence and dysuria.

Actinomycosis↗
PubMed1979

[Thoracic actinomycosis with superior vena cava obstruction (author's transl)].

In a 40-year-old farmer's wife presenting with fatigue, shortness of breath on exertion and occasional extrasystoles a space-occupying lesion of the mediastinum leading to obstruction of venous return in the superior vena cava was found. Prior to intended surgery the patient suddenly died following cerebral haemorrhage. Actinomycosis of the mediastinum leading to almost complete stenosis of the superior vena cava was found at necropsy.

Actinomycosis↗
PubMed2001

Abdominal actinomycosis: complication of endoscopic stenting in chronic pancreatitis?

Pancreatic endotherapy is frequently performed in patients with chronic pancreatitis and stenoses of the main pancreatic duct. In a patient with long-standing chronic pancreatitis and treatment with pancreatic stents, metastatic pancreatic head carcinoma was suspected because of infiltration of the neighboring organs and hepatic lesions. Ultrasound-guided aspiration of one liver lesion revealed grains typical for actinomycosis. In the light of this case, an extracted pancreatic stent was microbiologically investigated for actinomycetes in another patient who had a suspicious lesion of the pancreatic head. Microbiological examination of the extracted pancreatic stent revealed colonization by Actinomyces meyeri, Klebsiella oxytoca, and mixed cultures of anaerobic and saprophytic Gram-positive bacteria. In the following weeks, she developed a septic clinical picture with multiple abscesses of the liver. Actinomyces meyeri, Corynebacterium species, Candida and Enterococcae were cultivated in the aspirates. It seems possible, that treatment with pancreatic stents could have caused invasion of actinomycetes into the parenchyma of the pancreas, which was already harmed by the chronic inflammation, followed by the typical infiltrative growth and hematologic or biliary seeding into the liver.

Actinomycosis↗
PubMed2004

Cerebral actinomycosis before adolescence.

In a 10-year-old boy presenting with focal seizures and 6 months later with acute right-sided hemiparesis, the diagnosis of a cerebral abscess due to Actinomyces israelii was established. The immunocompetent child suffered from a complex congenital heart disease with pulmonary arteriovenous shunts and pulmonary hypertension causing mild cyanosis. His parents had been reluctant to agree to neuroimaging investigations resulting in a delayed diagnosis. Despite the long interval between first symptoms and commencement of treatment including neurosurgical excision of the abscess followed by a 4-week course of ceftriaxone, a complete recovery of the hemiparesis was observed. This patient is the first case with cerebral actinomycosis before adolescence reported so far.

Actinomycosis↗
PubMed1995

[Actinomycosis and the intrauterine spiral].

Genital actinomycosis infections are relatively rare and show a strong coincidence with long-lasting IUD application. Two patients without symptoms, where diagnosis was made by means of Papanicolaou smears were compared with two patients, where removal of a tubo-ovarian mass led to diagnosis. A general agreement about diagnosis and especially screening tests is still missing, but there seems to be a consensus regarding the types of IUD, the duration of use, and the sexual behaviour of the couple.

Abdominal Abscess↗
PubMed1992

[Infiltrating tubo-ovarian abscess in IUD-associated actinomycosis].

We report on a case of a 55-year old patient with a great adnexal tumour (10 x 5 x 8 cm), on the left side with infiltration of the bladder and the pelvis with recurring urinary retention in the kidney. Histological examination revealed an intrauterine device-associated actinomycosis. Following a 6-month high dose penicillin therapy, the abdominal hysterectomy with adnexectomy and partial resection of the bladder with new implantation of the ureter (Boari) was performed. The postoperative period was uneventful, the urogram normal.

Abscess↗
PubMed1998

[Cervical actinomycosis in systemic lupus erythematosus, nephrocalcinosis and distal renal tubular acidosis (type I-RTA)].

HISTORY AND CLINICAL FINDINGS: A 25-year-old woman presented with a painful soft-tissue swelling in the right neck, which made it impossible to assess the right cervical lymph nodes, while other lymph nodes were unremarkable on palpation. For 9 years she had been known to have polyarthritis. All joints were freely mobile and were without deformity or inflammatory signs. Flexion of the left elbow was slightly painful but freely mobile. There was no skin rash. INVESTIGATIONS: Erythrocyte sedimentation rate was 44 mm/h, there was a leucocytosis of 16,000 granulocytes/ml. There was hypokalaemia (3.5 mEq/l) and a metabolic hyperchloremic acidosis with a pH of 7.27 and a urinary pH of 6.5. Antinuclear and anti-ds-DNA antibodies were raised (ANA: 3.9 multiple of cutoff point [MOC; normal: 0-1.0]; anti-ds-DNA antibodies: 4.0 [normal: 0-1.0])-Fine needle aspiration cytology from the swelling revealed erythrocytes, double-refractory horny lamellae, cellular debris and only a few inflammatory cells. Abdominal ultrasound showed nephrocalcinosis. Microbiological cultures were negative. DIAGNOSIS, TREATMENT AND COURSE: Assuming a bacterial cause of the swelling antibiotic treatment with Phenoxymethylpenicillin (4 MU/d) was initiated. The local findings rapidly improved and the inflammatory parameters regressed to normal. 16 weeks after the initial admission the abscess recurred and biopsy now revealed actinomycetes with typical granules, confirming cervical actinomycosis. The other symptoms indicated autoimmune disease and, together with previous findings, established the additional diagnosis of lupus erythematodes, which caused the type 1 distal tubular acidosis. CONCLUSIONS: This case illustrates the basic approach of establishing an all-encompassing diagnosis that brings together seemingly isolated findings. It is especially in systemic disease that such diagnostic strategy will frequently lead to its recognition.

Acidosis, Renal Tubular↗
PubMed1990

[Combined surgical-antibiotic therapy of actinomycosis of the adnexa].

The majority of patients presenting with tubo-ovarian abscess caused by abdominopelvic actinomycosis are women using an IUD. Since the course of this disease is afebrile, and the diagnosis often established relatively late, it typically simulates a malignant tumour of the lower abdomen. Except for leukocytosis and an increased blood sedimentation rate, laboratory findings are within the normal range. The infection infiltrates neighboring structures, and hence a secondary involvement of the intestine is common. Two cases are presented, successfully treated by a combined operative-antibiotic approach.

Actinomycosis↗
PubMed1980

[Light and electron microscopy studies of actinomycosis of the lacrimal duct].

For the first time we present electron-microscopic results of an actinomycosis of the lacrimal canaliculus. The interior of the actinomycotic conglomerate showed no evidence of a cellular defence reaction but in the loosly woven outer network of hyphae we observed a massive granulocytic reaction. Also, after phagocytosis the structure of the actinomycotic micro-organisms within the granulocytes is not significantly damaged. Within the tissue of the lacrimal canaliculus adjacent to the actinomycotic conglomerate we observed an increased number of plasmacells but no pathogenic organisms.

Actinomycosis↗
PubMed1989

[Actinomycosis of the bladder].

A palpable tumour was discovered in the left lower abdomen of a 66-year-old woman with uncharacteristic lower-abdominal pain and treatment-resistant pollakisuria and stress incontinence. On ultrasound examination the tumour was about 6.0 x 2.5 x 2.5 cm in size and was located between bladder roof and anterior abdominal wall. Ultrasound-guided fine-needle biopsy failed to produce any cytologically interpretable material, and there was no bacterial growth from the aspirate. All clinical and biochemical findings were normal, except for a raised blood-sedimentation rate (15/43 mm). The tumour, completely removed at laparotomy, was diagnosed to be actinomycosis of the bladder. No long-term postoperative antibiotic treatment was undertaken. Nine months after the operation the patient was without symptoms and there were no abnormal clinical findings.

Actinomycosis↗
PubMed2002

Periappendiceal actinomycosis mimicking malignancy report of a case.

A case of a periappendiceal actinomycosis, seen in an 83-year-old woman, clinically mimicking a right ovarian neoplasm penetrating the right colon, is presented. The patient's complaints led to the discovery of a right abdominal mass. Explorative laparotomy and right hemicolectomy were done. Histological examination revealed periappendiceal actinomycotic abscesses. We discuss a possible pathogenesis and the therapeutic modalities.

Abscess↗
PubMed1978

Case report: primary actinomycosis of external oblique muscle.

A 67-year-old man had actinomycosis with primary involvement of the abdominal wall, which is rare. His chief complaint was an enlarging, hard, nontender mass in the right lower quadrant of the abdomen. The mass had been present for two weeks and measured 11 X 8 cm. An x-ray film of the chest, barium studies of the gastrointestinal tract, and an intravenous pyelogram showed no abnormalities. Excisional biopsy was performed, and the findings were consistent with Actinomyces israelii infection. There was no evidence of underlying bowel disease or break in continuity of the mucous membrane. The patient responded well to a three-month course of penicillin therapy.

Abdominal Muscles↗
PubMed2000

Actinomycosis of the colon: a rare form of presentation.

Actinomycosis is an uncommon entity, caused by an anaerobic bacterium, Actinomyces israelii, which is a component of the human oral and gastrointestinal flora. The cervicofacial region is the commonest site of disease, and the abdomen is the second commonest. In this situation the disease is almost always unifocal and restricted to the right colon, especially to the cecum. We report here the case of a patient with a very rare form of this entity, characterized by multiple foci of abdominal involvement with the most severe lesions localized in the transverse and sigmoid colon. The clinical presentation resembled a picture of colon perforation by cancer or diverticulitis, and the diagnosis was made by histopathologic examination of the lesions removed at surgery. No predisposing factor was found. The infection was successfully treated with a prolonged course of penicillin, after the surgical removal of the lesions.

Actinomycosis↗
PubMed2002

Ureteric obstruction caused by pelvic actinomycosis.

Ureteric obstruction is a well-known complication of actinomycosis, however its management in previous case reports has been very variable and sometimes mutilating. We report a rare case presenting with ischiorectal abscess that was successfully treated by JJ stenting and penicillin.

Actinomycosis↗
PubMed2003

Actinomycosis of the masseter muscle: report of a case and review of the literature.

A rare case of cervicofacial actinomycosis arising primarily in the masseter muscle is described. The patient was a healthy 74-year-old woman who was not immunocompromised and had no other primary pathological finding in the oral cavity. The importance of the differential diagnosis for this unusual infection is demonstrated with tumoral pathological findings. Possible predisposing factors as well as diagnostic and therapeutic methods are discussed.

Actinomycosis, Cervicofacial↗
PubMed2001

Rhinoorbitocerebral actinomycosis.

PURPOSE: To report a case of actinomycotic orbital abscess with subdural empyema and pansinusitis, an unusual presentation of a rarely seen infection. METHODS: Case report. RESULTS: A 35-year-old man sought treatment for signs and symptoms of an orbital abscess 22 days after a dental extraction. Computed tomography demonstrated a left orbital abscess with left pansinusitis and a large subdural empyema. Surgical clearance of all purulent material was done followed by prolonged penicillin therapy. Culture of pus from all sources yielded Actinomycosis israelii. At the time of discharge and 1-month follow-up, the patient had 20/20 vision with no neurologic deficits. CONCLUSIONS: In orbital infections with atypical presentations, unusual pathogens should be considered as the causative agents.

Abscess↗
PubMed1995

IUD-associated pelvic actinomycosis: a report of five cases.

Five cases of intrauterine device (IUD)-associated tuboovarian actinomycosis are presented. The patients' ages ranged from 33 to 49 years and their IUD usage from 2 to 12 years. Clinical features of the cases included stenosis of the sigmoid colon in 4 cases, ureteric or bladder obstruction in two cases, and rectal fistula in a further instance. All patients were successfully treated postoperatively with penicillin or ampicillin. An initial diagnosis of ovarian carcinoma was considered in all cases. Although Actinomyces is difficult to differentiate histopathologically from microorganisms and other substances that cause the Splendore-Hoeppli phenomenon, morphological diagnosis permits a quicker and more practical approach than bacterial cultures in the establishment of postoperative antibiotic treatment. Intraoperative frozen-section diagnosis of an acute inflammatory process permits the surgeon to make an immediate decision in order to avoid extensive surgery when ovarian carcinoma is suspected.

Actinomyces↗