The diagnosis and management of pulmonary actinomycosis

Boot, Madison; Archer, Jack; Ali, Ishad

doi:10.1016/j.jiph.2023.02.004

Cited by 12 publications

(2 citation statements)

References 165 publications

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“…After 12 weeks of treatment, he reached a viral load of 164 copies/ml. Even though recurrence of invasive actinomycosis is extremely rare, [22] presence of immunocompromised state such as untreated HIV infection; puts patients increased risk of recurrence especially if the CART is inconsistent. Our case did not present recurrent actinomycosis because there was clinical and structural resolution of esophageal ulcers.…”

Section: Discussionmentioning

confidence: 99%

Unmasked immune reconstitution inflammatory syndrome towards B-cell non-Hodgkin lymphoma during treatment of esophageal actinomycosis in a patient with advanced HIV: a case report

Vargas-Garcia

Fernandez-Aristi

Cornejo-Venegas

et al. 2023

Preprint

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Background Actinomycosis is an unusual chronic bacterial infection, even rarer in people living with HIV. It is not considered an AIDS-defining disease. However, the role in co-presentation or overlap with other opportunistic conditions of advanced HIV is unknown.Case presentation: A 49-year-old Peruvian male presented with a 4-month history of dysphagia, odynophagia, hyporexia and wasting. He underwent an upper digestive endoscopy, in which ulcers with a necrotic center were observed, therefore, the initial diagnostic assumption was esophageal cancer. Subsequent pathology report excluded neoplasms and confirmed the diagnosis of actinomycosis. Serology for human immunodeficiency virus was requested, yielding a positive result. Antimicrobial treatment with amoxicillin and antiretroviral therapy were indicated, with slow clinical improvement. After 4 months, epigastric discomfort presented, for which a new upper digestive endoscopy was performed, revealing a deep gastric ulcer, which was compatible with diffuse large B-cell non-Hodgkin lymphoma.Conclusion Esophageal actinomycosis in people living with HIV is very rare. We suggest HIV-associated immunosuppression is not enough to allow for actinomycosis to develop, and masked underlying entities should be sought. The existence of such entities in people living with HIV should raise awareness of the possibility of unmasked immune reconstitution inflammatory syndrome once treatment has started.

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Section: Discussionmentioning

confidence: 99%

Unmasked immune reconstitution inflammatory syndrome towards B-cell non-Hodgkin lymphoma during treatment of esophageal actinomycosis in a patient with advanced HIV: a case report

Vargas-Garcia

Fernandez-Aristi

Cornejo-Venegas

et al. 2023

Preprint

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“…Actinomyces are lamentous Gram-positive obligate anaerobic bacteria. Actinomycosis is classically divided into three types according to the sites involved: cervicofacial (55%), abdominopelvic (20%) and thoracic(15%) [1][2].Pulmonary actinomycosisis as a rare infection is commonly confused with other lung diseases, such as lung cancer, tuberculosis, pneumonia and aspergillosis [3][4][5].Pulmonary actinomycosis, with Fungus and/or tuberculosis co-infection is rare although the numbers of cases are increasing [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary actinomycosis with polymicrobial co-infection presenting as pulmonary abscess：a case report

Song¹,

He²,

Xiong³

2023

Preprint

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Background: Pulmonary actinomycosis is very rare. It is often misdiagnosed as lung cancer, tuberculosis, pulmonary aspergillosis or pulmonary abscess. Predisposing factors are immunosuppressive conditions, poor oral hygiene and chronic lung disease. Co-infection with different strains of actinomycetes, aspergillus and bacteria is rarely reported, which is a major cause of treatment failure. Case presentation：We reported a case of 63-year old woman with 3-month history of cough, expectoration and occasional hemoptysis. Pulmonary actinomycosis with polymicrobial co-infection including actinomyces mucous, actinomyces graevenitzii, aspergillus, klebsiella pneumoniae and streptococcus constellations in left inferior lobe was confirmed by etiological culture. Combined antibiotic therapy and bronchoalveolar lavage were administrated successfully. The clinical symptoms and radiologic abnormalities had improved significantly. Conclusions:Pulmonary actinomycosis is often misdiagnosed because of the nonspecific clinical manifestations and laboratory tests.Bronchoscopy plays a key role in the diagnostic and therapeutic pathways. Co-infection make the treatment more difficult. This case improves our understanding of the diagnosis and comprehensive therapeutic strategies for pulmonary actinomycosis with polymicrobial co-infection in the elderly.

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The role of Actinomyces spp. and related organisms in cervicofacial infections: Pathomechanism, diagnosis and therapeutic aspects

Kövér,

Johansen Nordskag,

Bán

et al. 2023

Anaerobe

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The diagnosis and management of pulmonary actinomycosis

Cited by 12 publications

References 165 publications

Unmasked immune reconstitution inflammatory syndrome towards B-cell non-Hodgkin lymphoma during treatment of esophageal actinomycosis in a patient with advanced HIV: a case report

Unmasked immune reconstitution inflammatory syndrome towards B-cell non-Hodgkin lymphoma during treatment of esophageal actinomycosis in a patient with advanced HIV: a case report

Pulmonary actinomycosis with polymicrobial co-infection presenting as pulmonary abscess：a case report

The role of Actinomyces spp. and related organisms in cervicofacial infections: Pathomechanism, diagnosis and therapeutic aspects

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