Ocular Actinomycosis Mimicking Meningioma

Kobayashi, Takaaki; Ford, Bradley; Fujita, Nobuhiro; Appenheimer, A. Ben

doi:10.1093/ofid/ofaa170

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…In 92% of cases, the diagnosis was not suspected at admission. This infection frequently misdiagnosed with neoplastic processes, such as meningioma,[ 6 , 8 , 12 , 13 ] granulomas, and osteomyelitis secondary to tuberculosis or nocardiosis. [ 22 , 25 ] In the present case, we did not consider actinomycosis in the initial differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

^99mTc-UBI 29-41 bone SPECT/CT scan in craniofacial Actinomyces israelii: Misdiagnosis of cranial bone tumor – A case report

Cerda-Vargas

Rangel

Mata

et al. 2020

Surgical Neurology International

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Background: Actinomycosis is a rare infection, frequently misdiagnosed as a neoplasia. This chronic and granulomatous disease is caused by Actinomyces israelii species. Cervicofacial actinomycosis occurs in 60% of cases and the diagnosis is commonly made by histopathology study. Case Description: We report a case of fronto-orbital osteomyelitis initially misdiagnosed as a cranial bone meningioma, but later proved to be a case of actinomycosis. 99mTechnetium (99mTc) three-phase bone single-photon emission computed tomography/computed tomography (SPECT/CT) and 99mTc-ubiquicidin (UBI) 29-41 bone SPECT/CT scans were performed to corroborate the control of the infection. Conclusion: Craniofacial actinomycosis is the most common presentation of actinomycosis. However, it continues to be a rare and difficult disease to diagnose and is often confused with a neoplastic process. The 99mTc-UBI 29-41 bone SPECT/CT scan could be an auxiliary noninvasive diagnostic alternative and a follow-up method for these patients.

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Section: Discussionmentioning

confidence: 99%

^99mTc-UBI 29-41 bone SPECT/CT scan in craniofacial Actinomyces israelii: Misdiagnosis of cranial bone tumor – A case report

Cerda-Vargas

Rangel

Mata

et al. 2020

Surgical Neurology International

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“…Chronic, suppurative, and granulomatous infections may occur at various anatomical sites when triggered by disruption of the mucosal barrier. 5 Although ocular actinomycosis is relatively rare, Actinomyces species have been isolated from cases of endophthalmitis, 6 keratitis, 7 orbital cellulitis, 8 dacryoadenitis, 9 dacryocystitis, 10 and canaliculitis. 11 Of these, canaliculitis is a major form of ocular infection.…”

Section: Introductionmentioning

confidence: 99%

Actinomycotic primary canaliculitis: Predisposing factors, clinical characteristics, and treatment outcomes

Ding

Zhang

Feng

et al. 2023

European Journal of Ophthalmology

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Objective Ocular actinomycosis is an uncommon progressive infection. The study aims to investigate the predisposing factors, clinical characteristics and treatment outcomes of culture-proven cases of Actinomycotic primary canaliculitis. Methods Single-center, retrospective, interventional case series. Culture-proven cases of Actinomyces-associated primary canaliculitis diagnosed and treated between January 2017 and December 2021 at the Beijing Tongren Eye Center, Capital Medical University were identified and reviewed for ocular and systemic risk factors, clinical presentations, microbiological profile, treatment modalities and outcomes. Results Of the 201 patients diagnosed with primary canaliculitis, 22 (10.9%) were caused by Actinomyces. The mean age at onset of 22 patients (21 women and one men) was 54 years. The lower canaliculus was most commonly involved (54.6%). The most frequent symptom was mattering without epiphora (77.3%) and clinical signs were punctal regurgitation of purulent discharge (100%) and expressible concretions (95.5%). Dry eye co-existed in 77.3% of patients, whereas no obvious systemic factors were found. Among 19 cases (86.0%) of identified Actinomyces species, A. odontolyticus (43.5%) was the predominant causative microorganism. There were 50% of patients with polymicrobial infection and the most common additional bacteria isolated were Streptococcus species. Conservative therapy combining repeated canalicular expression and irrigation with susceptible topical antibiotics achieved complete resolution in 86.4% of patients. Conclusions Dry eye was identified in the vast majority of patients with Actinomycotic canaliculitis. Most cases are odontogenic in origin and the infection occurs in immunocompetent individuals. The conservative method combining canalicular expression and irrigation with topical susceptible antibiotics is recommendable as initial therapy.

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Three cases of Actinomyces isolation from the eye lesions of patients with a chronic and recurrent ophthalmic infection

Kirti,

Sharma,

Gajashree

2022

Microbiology Independent Research Journal (MIR Journal)

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Actinomycosis is an indolent, slowly progressive infection caused by Gram-positive facultative anaerobic bacteria from the genus Actinomyces. These bacteria have been reported as a cause of ophthalmic infections such as endophthalmitis, keratitis, and canaliculitis. The objective of the present study was to investigate the pattern and antibiotic sensitivity profile of anaerobes isolated from lesions in the medial canthus of the eye. Three pus aspirate samples (from eye) were delivered to a microbiology laboratory in a strict anaerobic condition in Robertson Cooked Meat media (RCM). The samples were inoculated on Blood Agar and incubated anaerobically in a Gas Pack Jar incubator at 5%-10% CO2 and in aerobic condition at 37°C. Pure colonies isolated on anaerobically incubated plates were identified by the VITEK® 2 COMPACT system. Antibiotic sensitivity testing was conducted using an Epsilometer-strip test. Three isolates identified and confirmed with the help of VITEK® 2 were Actinomyces israelii, Actinomyces odontolyticus, and Actinomyces meyeri. All three species of Actinomyces were sensitive to Vancomycin, Moxifloxacin, and Imipenem, but they were resistant to Metronidazole. Since there have been several cases of anaerobic ophthalmic infections reported to date, samples from patients with chronic eye infections should be analyzed for anaerobic culture for correct diagnosis and proper treatment. Moxifloxacin but not Metronidazole is a suitable drug for the treatment of anaerobic eye infection.

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Ocular Actinomycosis Mimicking Meningioma

Cited by 3 publications

References 10 publications

^99mTc-UBI 29-41 bone SPECT/CT scan in craniofacial Actinomyces israelii: Misdiagnosis of cranial bone tumor – A case report

^99mTc-UBI 29-41 bone SPECT/CT scan in craniofacial Actinomyces israelii: Misdiagnosis of cranial bone tumor – A case report

Actinomycotic primary canaliculitis: Predisposing factors, clinical characteristics, and treatment outcomes

Three cases of Actinomyces isolation from the eye lesions of patients with a chronic and recurrent ophthalmic infection

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