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[Hepatic actinomycosis].

We present a case of primary liver actinomycosis in a patient who was operated on for a duodenal ulcus seven years before. A gastrectomy was performed. His gallbladder was also removed two years before. After the surgical treatment, followed by antibiotic and chemotherapeutic treatment, with the result of a pretended success, the patient developed a liver pyogenic abscess and portal hypertension. Authors emphasise the seriousness of the illness as well as its rarity even with an accurate treatment.

Actinomycosis↗

[Pleuro-mediastinitis in pulmonary actinomycosis as a rare differential bronchial carcinoma diagnosis].

A 48-year old patient complaining of immitigable coughing with purulent and sanguineous sputum and a loss of weight of 8 kg within the last three months was admitted to our hospital. Due to anamnesis and radiological findings (tumor of the right side upper lung field with infiltration of the chest wall and the mediastinum) we suspected a bronchogenic carcinoma. As bronchoscopy and histological examinations of biopsies revealed no hints to the underlying disease, we submitted the patient to a right side explorative thoracotomy. It showed a tumorous involvement of the right side upper lung field with infiltration and partial destruction of the chest wall and infiltration of the apical segment of the lower lobe of the lung and a phlegmonous infiltration of the paratracheal tissue. Histological examination confirmed chronical course of actinomycosis. Therapy consisted in resection of the affected tissue and long-term administration of antibiotics. Response to therapy was excellent concerning both radiological findings and subjective complaints.

Actinomycosis↗

Gastric actinomycosis.

A case of actinomycosis of the stomach in a 61-year-old woman is reported. The patient presented to the hospital with a history of epigastric pain, fatigue, poor appetite, constipation and mild fever of 20 days' duration. On physical examination, a tender mass was felt at the epigastrium. Computed tomography (CT) showed a heterogeneously enhanced mass at the posterior wall of the stomach. Upper gastrointestinal series revealed a submucosal mass at the gastric antrum. A malignant tumor was suspected and surgery was recommended. A 5 x 4 x 2 cm mass was found at the posterior wall of the distal gastric antrum. A Billroth II subtotal gastrectomy was performed. Pathologic examination revealed suppuration and sulfur granules in the indurated mass. The patient was subsequently treated with intravenous penicillin-V for 12 days and then with oral penicillin-G for 4 months. She remained well at her last follow-up appointment. Although the initial radiologic findings were nonspecific, CT was of importance in delineating the location and evaluating the extent of the lesion.

Actinomycosis↗

[Primary bronchial actinomycosis and foreign body].

This paper presents the fourth case reported on the association of primary bronchial actinomycosis and foreign body. The pathogenesis of this rare association has been linked to the low respiratory tract and a foreign body (chicken bone); it depends on its characteristics and how long it has remained lodged into the bronchial tree. The diagnosis of this case was very difficult and late. Several endoscopy procedures were required in order to detect it. Our patient has been treated successfully with parenteral penicillin in association with an original bronchoscopic procedure using a laser technique to find the foreign body and take it out of the respiratory tract. We consider that it is necessary to remember this association in every patient who suffers from recurrent pneumonia, in those who are at risk of foreign body aspiration and when the presence of an endobronchial mass is suspected.

Actinomycosis↗

[A rare cause of retroperitoneal fibrosis: actinomycosis].

The authors report a case of retroperitoneal fibrosis secondary to actinomycosis with consequences on the urinary tract. They insist on the difficulty of diagnostic, the antibiotic's sensibility and the evolution towards fibrosis which can lead to renal function deterioration.

Abdominal Abscess↗

[Endobronchial actinomycosis].

A 63-year-old man was admitted to our hospital with obstructive pneumonia. The chest X-ray film and computed tomogram showed an infiltrative shadow in the right lower lung field. Examination with a fiberoptic bronchoscope showed a mass in the right basal bronchus. These findings suggested the diagnosis of lung cancer with obstructive pneumonia. Histopathological examination of a specimen obtained by transbronchial biopsy revealed sulfur granules with infiltration of neutrophils, which led to the diagnosis of endobronchial actinomycosis. After three months of treatment with penicillin, the mass disappeared. Comparison of bronchoscopic findings before and after penicillin treatment clearly showed the efficacy of therapy.

Actinomycosis↗

Cervicofacial actinomycosis with paravertebral spread: a case report.

We report a case of cervicofacial actinomycosis with paravertebral extension in a 60-year-old man who presented with recurrent neck masses. Diagnosis was confirmed on culture and histology of pus and debris obtained from surgical drainage. He improved only after lengthy in-hospital high dose penicillin therapy. He is currently well and is on maintenance doxycycline therapy for 6 months following the high dose penicillin therapy.

Abscess↗

Primary actinomycosis of the urinary bladder. Case report and review of the literature.

The case of a female patient, aged 37, with signs of partial intestinal obstruction, repeated cystitis and a tumoral mass in the hypogastrium is reported. Preoperative examinations could not establish the nature of the tumour. Colonoscopy as well as barium enema stopped at a sharp angulation of the sigmoid. Laparotomy evidenced an inflammatory tumour, with departure point in the urinary bladder, which involved the sigmoid and the uterus. After adhesiotomy a partial cystectomy was performed. The macroscopic aspect of the bladder was pseudopolypoid, while the microscopic one was typical for actinomycosis. The patient was discharged cured and was prescribed a penicillin course for 4 weeks.

Actinomycosis↗

[A rare case of primary abdominal actinomycosis].

The authors describe a case of primary abdominal actinomycosis operated on because of peritonitis sustained by a tubo-ovarian abscess. They discuss the pathogenesis of the case: the patient had been on intrauterine device contraception till two months earlier and had been operated on for breast cancer. Preoperative diagnosis is quite impossible and only the microscopic observation of the specimen can show the causative agent. Surgical options are reported, stressing the need for an adequate period of antimicrobial therapy.

Abscess↗

[Abdominal actinomycosis with IUD].

We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.

Abdominal Abscess↗

[Pelvic actinomycosis abscess and intrauterine device].

A case of association between IUD and a left tubal actinomycotic abscess is presented. The 45 year old patient was wearing an IUD for five years. The symptomatology was mainly that of pelvic pain with an associated mass in the left iliac fossa. The working diagnosis was that of a digestive tumor or an adnexal mass. The surgical procedure allowed to identify an inflammatory reaction with a pseudotumoral abscess formation in the left fallopian tube. The etiology was confirmed by the pathology and bacteriology reports. Treatment consists in surgical extirpation of the infected structures and long term antibacterial therapy. Actinomycosis is a rare but potentially serious pelvic disease. It may involve various organs and readily takes on the aspect of tumor formation.

Abscess↗

[Mandibular actinomycosis].

We report a case of mandibular actinomycosis secondary to dental surgery in a 19-year-old male. The major features of this clinical entity are described. Loss of the integrity of the oral mucosa was the determinant factor in our case. Systematic realization of panoramic radiographs of the jaw is proposed as a means of excluding lower maxillary involvement secondary to Actinomyces infection.

Actinomyces↗

[Pulmonary and musculo-cutaneous thigh actinomycosis].

We report a case of actinomycosis presenting with both a thigh abscess and a pulmonary lesion. Diagnosis was obtained by biopsy of this abscess, showing sulfur granules and further identification of Actinomyces israelii together with Actinobacillus actinomycetemcomitans in culture. Furthermore. Actinomyces israelii was isolated from bronchial secretions.

Abscess↗

[Cervicofacial actinomycosis].

Actinomycosis is an infectious disease that appears throught the world, in cattle and human beings. It is a chronic granulomatous and suppurative lesion, usually affecting the cervicofacial area. Definitive diagnosis, by culture or biopsy, is not always possible, so the clinician must suspect it by its clinical presentation. It is the purpose of this article to present the patients diagnosed and treated in our Department during the last 5 years, and to review the ideal therapy.

Actinomycosis, Cervicofacial↗

Advanced actinomycosis involving urogenital organs simulating malignancy: a case report.

A long-standing and widely used intrauterine contraceptive device has been associated with actinomycotic pelvic inflammation. The stealthy and chronic nature of the disease progresses and occasionally infiltrates adjacent organs. The non-specific symptoms of the disease, solid invasive mass and lack of marked leukocytosis, often suggest a malignancy. We present a case of advanced pelvic actinomycosis involving urogenital organs which has not been reported before. The behaviors of the disease, which mimic malignancy and urogenital manifestation, pose difficulties in diagnosis and management.

Actinomycosis↗

[A patient with generalized actinomycosis].

A 36-year-old man was admitted because of haemoptysis and weight loss. Despite elaborate investigations, including multiple biopsies of affected organs (pleura, lung, kidney and liver) no diagnosis was established. The patient refused further diagnostic procedures and left hospital for winti treatment in Surinam. He did not take the prescribed pheneticillin and returned after seven weeks in a very poor condition. The second admission was complicated by septic shock. Despite intensive treatment he died. On autopsy actinomycosis abscesses were found in lung, liver and kidney. Even when suspected, an infection with Actinomyces is difficult to diagnose. Without adequate treatment this infection can lead to life-threatening complications.

Abscess↗