Actinomycosis, a lurking threat: a report of 11 cases and literature review

Paulo, Catarina Oliveira; Jordão, Sofia; Pinto, João Correia; Ferreira, Fernando; Neves, Isabel

doi:10.1590/0037-8682-0215-2017

Cited by 13 publications

(8 citation statements)

References 24 publications

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“…Perforated appendicitis is the most frequent cause of this subtype [ 8 ]. It can also be related to abdominal trauma, recent abdominal surgery, diverticulitis, abdominal perforation, neoplasia [ 3 - 6 ], or the use of intrauterine contraceptive devices [ 3 , 6 , 7 ]. There are also reported cases associated with poor dental hygiene [ 1 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Appendicular Actinomycosis: Behind the Curtains of Appendicitis

Completo¹,

Verı́ssimo²,

Pereira³

et al. 2022

Cureus

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Actinomycosis is a rare, indolent, and multisystemic infection caused by Actinomyces, commensal bacteria of the oral and intestinal flora. It usually occurs due to tissue disruption. It affects the abdominal region in 20% of cases, and the most common presentation is a perforated appendix. Symptoms are nonspecific, which makes differential diagnosis a challenge.We present the case of a healthy, nine-year-old boy of African ancestry with a five-month history of recurrent intermittent abdominal pain in the periumbilical and right lower quadrant areas. He recurred to the emergency department with symptoms suggestive of acute appendicitis and was submitted to an emergent laparotomy. The histologic examination revealed Actinomyces colonies compatible with the diagnosis of appendicular actinomycosis. He was treated with intravenous penicillin for a month and, subsequently, with oral amoxicillin for a year. He had complete remission of symptoms.Actinomycosis is a rare entity, particularly in children. Nevertheless, it should be considered in the differential diagnosis of an intrabdominal mass or unspecific recurrent, indolent, and abdominal pain. As symptoms are nonspecific, it can mimic other diseases. It is mostly diagnosed post-operatively, after histological examination. Early treatment is important to avoid recurrence, and, therefore, a high index of suspicion is required.

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Section: Discussionmentioning

confidence: 99%

“…It affects predominantly in the cervicofacial region, followed by abdominal and thoracic regions [ 4 - 6 ]. Perforated appendicitis is the most frequent presentation of abdominal actinomycosis [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Appendicular Actinomycosis: Behind the Curtains of Appendicitis

Completo¹,

Verı́ssimo²,

Pereira³

et al. 2022

Cureus

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“…They can affect many sites of humans, such as the cervicofacial (50-60%), thoracic actinomycosis (15-20%), abdominopelvic (20%), the central nervous system (2%), and rarely involves cutaneous, ophthalmic, musculoskeletal disease, pericarditis, genitourinary or disseminated disease [5]. As for thoracic actinomycosis, the most common etiology of infection is poor dental hygiene and diabetes, HIV infection, malignancies, steroid, obesity, alcoholism, and age > 65 years are risk factors for developing thoracic actinomycosis [6]. Otherwise, patients with chronic obstructive pulmonary disease, pulmonary sequelae following tuberculosis and with the aspiration of foreign bodies [7,8], are considered to also be risk factors [9].…”

Section: Discussionmentioning

confidence: 99%

Actinomyces as a Cause of Unexplained Fever Diagnosed by Next-Generation Sequencing: Case Report and Review

Huang¹,

Du²,

He³

et al. 2021

Preprint

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Background: Actinomycosis is a rare cause of unexplained origin fever (FUO). The NGS, particularly in cases of FUO in conventional microbiology, is a promising and advantageous technology for earlier diagnosis and more success. It gives new insights in the management of FUO, especially in infectious diseases.Case presentation: We present a case of a 71-year-old woman who had FUO that the etiology was endobronchial actinomycosis eventually diagnosed by next-generation sequencing of bronchoalveolar lavage fluid. She was admitted to the our department with intermittent fever up to 40.0℃, chills, cough with white sputum, chest distress and slightly dyspnea over one month. According to special clinical course and laboratory data of the patient, she was given intravenous sulbenicillin sodium for 11 days and oral amoxicillin at 500 mg every 8 h for another 1 month. When she returned for follow-up, she reported a notable improvement in her cough, dyspnea, sputum production and fever that was completely absent.Conclusion: In obscure causes of FUO, clinicians should consider the possibility of thoracic actinomycosis and actively use next-generation sequencing to help diagnose.

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“…However, risk factors associated with the acquisition of Actinomyces are immunosuppression, diabetes and between 20-year-old and 60-year-old age group 15. In a paper by Paulo et al , 10 out of the 11 patients reported to have at least one factor of immunosuppression 18. Given the rarity of such infection in general across the population, the authors have called for patients to be screened for HIV infection and malignancies.…”

Section: Discussionmentioning

confidence: 99%

“Fungating” tumour? No, it’s bacterial!

et al. 2019

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A fit and healthy 26-year-old woman presented to the general surgical team with epigastric pain and weight loss of 2 stones over 6 months. She has also a positive family history of ulcerative colitis. As her oesophagogastroduodenoscopy and colonoscopy were normal, a contrasted CT was requested, and it detected an inflammatory mass with fat streaking around her transverse colon. An intrauterine contraceptive device (IUCD) was noted. In light of the CT findings, she underwent a diagnostic laparoscopy. As the inflammatory mass was not separable from the transverse colon, a segmental transverse colectomy was proceeded. The histology revealed multiple actinomycosis abscesses in the mesentery. Subsequently, we learnt that her IUCD had been in situ for the last 7 years, and the source of actinomycosis abscesses is likely from her IUCD. The patient was recommended to have the coil removed and commenced on a 6 months course of amoxicillin.

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Actinomycosis, a lurking threat: a report of 11 cases and literature review

Cited by 13 publications

References 24 publications

Appendicular Actinomycosis: Behind the Curtains of Appendicitis

Appendicular Actinomycosis: Behind the Curtains of Appendicitis

Actinomyces as a Cause of Unexplained Fever Diagnosed by Next-Generation Sequencing: Case Report and Review

“Fungating” tumour? No, it’s bacterial!

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