A Rare Case of Actinomyces odontolyticus Infection after Injection Laryngoplasty with Deflux

Munroe, Kelti; Jonathan, M Fishman; Brown, Timothy A.

doi:10.23937/2572-4193.1510092

Cited by 1 publication

(2 citation statements)

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“…A. odontolyticus is a resident bacterium of the oral cavity (being the main responsible for tooth biofilm formation), pharynx, distal esophagus, and distal urinary tract [1,36]. This pathogen has been reported to cause orocervicofacial [37][38][39], laryngeal [40,41], thoracic [42,43], renal [44,45], and pelvic actinomycosis [46,47], infection of the penile shaft [4], peritonitis [48], cholecystitis [49], liver abscesses [50,51], chronic conjunctivitis [52], spinal and brain abscesses (including meningitis) [53][54][55], foot, finger, arm abscesses [56][57][58], and other soft tissues involvement, such as cutaneous abscesses [59,60], osteomyelitis [61,62], purulent pericarditis [63,64], endocarditis [65], and BSI [66][67][68][69]. Looking at implant-associated infections with the contribution of A. odontolyticus, besides PVGI caused by A. odontolyticus [10,14,16,17], reports exist on endocarditis related to implantable cardioverter defibrillator [70], IUCD-associated pelvic actinomycosis [71,…”

Section: Discussionmentioning

confidence: 99%

“…Looking at implant-associated infections with the contribution of A. odontolyticus, besides PVGI caused by A. odontolyticus [10,14,16,17], reports exist on endocarditis related to implantable cardioverter defibrillator [70], IUCD-associated pelvic actinomycosis [71,72], and dental implant fixtures infection [73]. Dental or oral conditions [54,63,64], intravenous drug abuse [60,67], toothpick skin puncture [56], surgery of the gastrointestinal tract [62], laryngeal injections [41], and urologic procedures [4,45,74] have been implicated in A. odontolyticus infection.…”

Section: Discussionmentioning

confidence: 99%

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Actinomyces spp. Prosthetic Vascular Graft Infection (PVGI): A Multicenter Case-Series and Narrative Review of the Literature

Del Fabro,

Volpi,

Fumarola

et al. 2023

Microorganisms

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Background: Actinomycosis represents a challenging and under-reported complication of vascular surgery. Optimal management of Actinomyces spp. prosthetic vascular graft infection (PVGI) is highly uncertain because of the paucity of reports on this disease. Methods: We conducted a retrospective case-series of Actinomyces-PVGI that occurred in the last five years in two major university hospitals in northern Italy. We searched for previously published cases in the scientific literature. Results: We report five original cases of Actinomyces spp. prosthetic vascular graft infection following aortic aneurysm repair. Our literature review retrieved eight similar cases. Most patients were immunocompetent males. Most infections were polymicrobial (11/13 cases), with a prevalence of A. odontolyticus involvement (3/13 cases were associated with. Salmonella spp. infection). All cases had a late presentation (≥4 months from graft placement), with 61% associated with an aorto-enteric fistula. All patients received antibiotic therapy, but the duration was highly heterogeneous (from two weeks to life-long antibiotics). The patients without surgical revision experienced septic recurrences (2/13), permanent dysfunction (1/13), or a fatal outcome (2/13), while of the remainder who underwent vascular graft explant, six recovered completely and one developed a periprosthetic abscess. In two cases follow-up was not available. Conclusions: This case-series aims to raise the diagnostic suspicion and to describe the current management of Actinomyces-PVGIs. We highlight a high heterogeneity in antibiotic duration, choice of the antibiotic regimen, and surgical management. Higher reporting rate is advisable to produce better evidence and optimize management of this rare complication of vascular surgery.

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