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9 cases of thoracic actinomycosis are analysed with regard to their antibiotic therapy. On account of sensibility of the bacteria and the pharmaco-kinetics of the antibiotics the therapy with Ampicillin in high doses is recommended for relatively short time. This therapy should be performed in any case before surgical measures.
A case of primary actinomycosis of the ear in a 15 year old Ethiopian girl is described and discussed.
Actinomycosis is a rare infection which can attack most parts of the body, even in normal individuals. In the gastrointestinal tract it may imitate acute appendicitis, Crohn's disease or tumors. We present a young soldier with appendiceal involvement who was mistakenly operated on. Because of its very good response to antibiotics, this infection should be recognized early and treated, to prevent prolonged, unnecessary suffering.
Hepatic actinomycosis is very rare. Usually, the specific diagnosis is only made after exploratory laparotomy and surgical drainage. We present a case diagnosed by cytologic study after fine needle aspiration biopsy. The treatment consisted of longterm antibiotic therapy, at high doses, without surgical drainage.
Thoracic actinomycosis was identified in a 14 year old girl. The disease is infrequent in children and diagnosis is difficult. The occurrence of a protracted pulmonary lesion, together with osteomyelitis of several ribs and by fistulae formation in the chest wall, with production of characteristic "sulfur granules", were the key elements to suspect the right diagnosis, which was confirmed by a bacteriological and histological studies. Treatment with high doses of intravenous penicillin, 3 million U four times a day for 4 weeks, followed by long term oral therapy with the same drug was done, with remission of pulmonary, osseous and cutaneous lesions.
We report a primary case of Actinomycosis of the abdominal wall. The diagnosis is obtained on the basis of the CT-scan and the pathological examination. The treatment is a surgical excision and a long term administration of antibiotics.
The here presented case was a woman 82 years old suffering for many years of arteriosclerotic Parkinson syndrome. During the last 8 months of her life she exhibited excessive talk flow and states of delirium. Twelve days before death she had a generalized attack of convulsions and the consciousness disorder increased. Moreover, meningeal symptoms were observed, a right side reflex syndrome with Babiński sign and temperature up to 38 degrees C were noted. Death occurred on the 9th day of hospitalization with symptoms of increasing circulatory-respiratory insufficiency. Pathomorphological examination revealed in the myocardium, lungs, liver, kidneys and thyroid multiple purulent foci containing actinomycotic granules. Neuropathological examination revealed both in the cortex and white matter the presence of numerous disseminate bodies staining intensively with HE, PAS- and Gram-Weigert positive and negative in the Ziehl-Nielsen method. Their structure, compact or fine-powdered corresponded to actinomyces colonies. They either showed no reaction or were surrounded by a wall of inflammatory cells such as: neutrophilic leucocytes, lymphocytes, plasmatic cells and histiocytes. The microabscesses were not encapsulated. The case was classified to a diffuse form of brain actinomycosis. The etiopathogenesis of the changes and the clinical-morphological correlations of this very rare infectious disease of the central nervous system are discussed.
The parotid Actinomycosis is a very uncommon infectious disease. In this article one case is presented discussing several aspects of its diagnosis and treatment.
A case of sigmoid actinomycosis is described in a women aged 41 years in whom clinical and intraoperative diagnosis was that of carcinoma. Laparotomy was performed with resection of the sigmoid with the tumour.
A case is presented of abdominal actinomycosis restricted to the cecum, with the appendix and terminal ileum spared. We analyze the clinical and diagnostic aspects, with their differential diagnoses, as well as medico-surgical therapeutic options.
A case is presented of actinomycosis that involved the lung and the liver, which was diagnosed after a computed-tomographic-guided needle biopsy of a liver mass. The diagnosis was made on histological grounds that were based on the staining and morphological characteristics of Actinomyces spp. Imaging techniques suggested a communication between the lung and liver lesions. The regression of the disease was followed during 12 months of therapy. The patient remained free of disease for three months after the cessation of treatment. The relevant literature is reviewed.
Cervico-facial actinomycosis is a chronic bacterial disease caused by actinomycetes. The diagnosis may be made on the specific anatomo-pathological appearance of the granulomas and be confirmed by anaerobic culture of the germs. The authors report two atypical cases: the first is a case of a thyroglossal pseudocyst, the second that of adenoidal vegetations in an adult. Treatment with Penicillin G or V for six weeks produced a favourable response. The various clinical forms of the condition described in the literature, should encourage the physician to include bacteriological testing for actinomycetes among his investigations.
Concerning five observations of cervico-facial actinomycosis in the O.R.L. ward of Charles-Nicolle hospital, authors report sings, diagnosis and bacteriology. The cure consists in the extracting of the teeth concerned, the removal of the necrosed tissues and an antibiotherapic treatment based on ligh doses of penicillin relaying with cyclins.
Primary hepatic actinomycosis is seldom seen, and almost all cases have been diagnosed by laparotomy. Treatment with high-dose parental penicillin for prolonged periods is recommended. In the past concomitant surgical drainage also has been recommended, but the nonoperative success reported here and by others suggests that surgical drainage is not essential to the treatment.
We report an unusual case of unresolved pneumonia in a 59 yr old woman due to endobronchial lipoma and actinomycosis, two rare diseases that have never been described before in the same person.
A brief review of the pathogenesis of actinomycotic infections, including cause, frequency, distribution, and symptoms has been presented. A relatively rare occurrence of actinomycosis in the tongue was reported to serve as an illustration of the diagnostic and therapeutic considerations pertinent to this disease.
A patient with actinomycosis, involving the meninges and right cavernous sinus, presented with diplopia due to a total right external ophthalmoplegia and left abduction weakness. These was partial right ptosis but the pupils were spared. The diagnosis was made by biopsy of a neck mass. A complete recovery was made in response to intravenous penicillin.
We report two cases of peritoneal actinomycosis, a rare localization of an uncommon disease (27% of the 212 cases previously published). The disease presents with tumoral symptoms. It is exceptionally diagnosed before surgery which usually consists of a safety excision. The true nature of the tumour is revealed by pathological examination, and its consequence is an antibiotic treatment. In the 2 cases reported here the patients had an old, uncontrolled intra-uterine device which might have been the portal of entry of the infection.