Actinomyces Species and Cerclage Placement in Neonatal Sepsis: A Case Report

Abstract

A 26-year-old female with a history of preterm labor and cerclage placement presented at 29 weeks gestation. Twin girls were delivered at 29 1 7 weeks. Twin A presented with clinical sepsis at birth. Twin A's blood cultures became positive for Actinomyces species on day of life 15. Despite aggressive medical management twin A died at 35 days of life.

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

“…Infections of the urogenital tract 19 , eye [20][21][22] , skin, and disseminated disease 23,24 focalized in the central nervous system (CNS) 25 are rare; a case of chronic lymphadenitis has also been reported 26 . Only vertical transmission has been reported, and two cases of neonatal sepsis have been described: one caused by A. neuii and the other (species unidentified) with uterine cerclage as the identifiable risk factor 27,28 .…”

Actinomyces in Pregnancy: A Review of the Literature

“…In our literature review, we identified 16 cases of Actinomyces in pregnancy (Table 1), [6][7][8][9][10][11][12][13][14][15][16][17][18][19] and we have had a single case at our hospital. We were unable to obtain 1 article from Croatia.…”

“…14,19 It is uncertain whether the cerclage incited a response in which Actinomyces was able to invade the normal defenses of the membranes resulting in the chorioamnionitis. In 2 of these cases, the patient had a cerclage in place.…”

“…14,19 There were 4 cases of a dental abscess, 7,13,18 2 cases of appendicitis, 9,12 2 cases of renal actinomycosis (1 of which also had a tooth abscess 13 ), 16 and 2 cases of ovarian abscesses. Two of these cases had a cervical cerclage.…”

“…10,17 Only 2 of the case reports noted an IUD history among the 17 patients. 10,[14][15][16]18 A potential concern of identifying Actinomyces in pregnant patients is that for most of these patients, the antibiotics chosen to treat the infection in pregnancy are also effective in treating Actinomyces. Endometrial actinomycosis with extension to the fallopian tubes and ovaries is a form of pelvic actinomycosis that has been commonly associated with IUDs.…”