Progressive Intractable Actinomycosis in Patients with AIDS

Abstract

Two rare cases of progressive oropharyngeal actinomycosis, characterized by a subacute and invasive course despite seemingly appropriate antibiotic and surgical treatment, have been observed in patients with AIDS. A brief review of previously reported cases of actinomycosis in HIV-infected patients is presented. Clinical, diagnostic and therapeutic problems dealing with actinomycosis in the immunocompromised host are discussed.

Intra-abdominal co-infection with Mycobacterium bovis and Actinomyces in an AIDS patient: The first reported case and review

“…3 Not considered an opportunistic infection, the prevalence of actinomycosis in individuals with HIV/AIDS does not seem increased compared with HIV-negative persons, with only 17 reported cases of such infections in HIV-positive individuals as of 2000. 4,5 In the abdomen, infection occurs after the organism seeds the cavity through a breach in the intestinal mucosa. 6 Like abdominal MTB, actinomycosis presents as a firm, indurated abdominal mass, which mimicks malignancy, inflammatory bowel disease, or appendicitis, but which over a period of weeks to months, can form recurrent cutaneous sinus tracts that spontaneously fibrose and heal.…”

Cutaneous Disseminated Actinomycosis in a Patient with Acute Lymphocytic Leukemia

“…These reports proposed the risk factors to be as follows: neoplasms, diabetes mellitus, steroid usage, or other debilitating diseases (10,11). Four out of eleven HIV-infected patients with actinomycosis have been intractable (7,(15)(16)(17)(18)(19)(20)(21). Among four cases in this series, three were caused by Actinomyces israelli (16,17,20) and one by Actinomyces naeslundii (7).…”

Actinomycosis in HIV infection: a review of a rare complication

“…Each sulphur granule consists of branching bacterial ® laments of Actinomyces which can be visualized on microscopic 350 International Journal of STD & AIDS Volume 11 June 2000 17 Vazquez et al 13 Manfredi et al 18 Kingdom and Tami 9 Manfredi et al 19 Watkins et al 14 20 Cendan et al 7 Klapholz et al Nair and Pitchumoni 22 Litt et al 23 Poles et al 24 Spencer et al 25 examination of a Gram-stained smear. Special histological stains such as Grocott± Gomori methenamine± silver nitrate and p-aminosalicylic acid may also be used.…”