A Case of Esophageal Actinomycosis in a Patient with Normal Immunity

Abstract

Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature. (Korean J Gastroenterol 2013;61:93-96)

Esophagitis Due to Actinomycosis in an Immunocompetent Patient with a History of SARS-Cov-2 Infection: Case Report

“…Esophageal epithelium with bacilliform structures consistent with actinomyces. Open Journal of Gastroenterology in the literature, according to the reviews of Murchan et al [5] and Abdalla et al [6] of them, nine were in patients with HIV infection; A new review of cases was carried out after what this article reported, finding 12 more cases of esophageal actinomycosis in patients with end-stage chronic kidney disease [7], non-small cell lung neoplasia (with a history of mediastinal radiation) [8], bronchogenic carcinoma [9], tracheal carcinoma [10], hematological malignancy [11], kidney transplant [12], diabetes [13], eosinophilic esophagitis [14], and immunocompetent [15] [16] [17], but no other cases in patients with HIV infection. but no other cases in patients with HIV infection.…”

Esophageal actinomycosis in a patient with end‐stage renal disease

“…Since the late 1980s, the spectrum of esophageal infections has continued to broaden, and our understanding of these infections has improved significantly as a result of emergence of AIDS, advancements in transplantation and immunosuppressive therapy, and improvements in endoscopic and microbiologic techniques. Timely and accurate diagnosis of esophageal infections is critical because treatment is highly effective and usually results in rapid symptomatic improvement and often clinical cure …”

“…Timely and accurate diagnosis of esophageal infections is critical because treatment is highly effective and usually results in rapid symptomatic improvement and often clinical cure. [1][2][3][4][5] Actinomycosis is an indolent, slowly progressive rare infectious disease caused by anaerobic or microaerophilic bacteria that normally colonize the mouth, colon, and vagina. It is most commonly caused by Actinomyces israelii.…”

“…Recently Kim et al also describes a case of esophageal actinomycosis in a patient with normal immunity. 1 The treatment of choice for actinomycosis remains penicillin, typically administered initially via intravenous route for 2-6 weeks, employing a dose in the range of 18-24 million units per day, followed by oral therapy with either penicillin VK or amoxicillin for 6-12 months. An immunocompetent patient with less severe infection, particularly when limited to the cervicofacial region, may not require such a prolonged course of treatment.…”

“…Actinomycosis of esophagus is rare. Very few cases have been reported in the literature in immunocompetent 1 and immunocompromised patients like acquired immunodeficiency syndrome (AIDS) or with malignancy. [2][3][4][5][6][7] We report a case of esophageal actinomycosis in an end-stage renal disease (ESRD) patient.…”