Unusual presentations of actinomycosis: a case series and literature review

Abstract

Introduction: To review unusual actinomycosis cases that appeared as a diagnostic and therapeutic challenge at our institution and to present a literature review on the usual clinical presentations.
 Methodology: This retrospective review included all patients hospitalized for actinomycosis in a 10-year period at the University Hospital for Infectious Diseases “Dr. Fran Mihaljević”, Zagreb, Croatia.
 Results: A total of 15 patients were hospitalized during the observed period, 9 (60%) females and 6 (40%) males. The localizations of actinomycosis were: pelvis (5), lungs (3), blood stream (2), colon (1), penis (1), stomach (1), skin (1), cervicofacial region (1).
 We present four unusual cases: subcutaneous actinomycotic abscess, actinomycosis of the stomach with underlying non-Hodgkin lymphoma, sepsis due to Actinomyces neslundii originated from chronic asymptomatic periapical tooth abscesses and actinomycosis of the distal part of the penile shaft.
 Conclusions: Actinomycosis was a very rare clinical problem in our clinical practice (0.032% of all hospitalizations and 0.0034% of all outpatients) but among those cases classical clinical presentations were also very rare.

Pulmonary actinomycosis mimicking lung malignancy: About two cases

“…Limited case series have indicated an increased prevalence of pulmonary actinomycosis among individuals with pre-existing chronic respiratory conditions, such as chronic bronchitis, emphysema, and bronchiectasis [ 4 , 13 ].…”

“…Bronchoscopy showed infiltration of the left upper lobe. Bronchoalveolar lavage [ 4 ] didn't show any bacteria. AFB search was negative in the bronchial fluid.…”

Recalcitrant Gastric Actinomycosis Treated With Over-the-Scope Clip

“… 7 , 8 In 1 series of 15 patients with actinomycosis, only 1 patient had gastric involvement. 9 Detection during endoscopy is even more infrequent. 7 , 8 , 10 We present a case of actinomycosis, which was found during endoscopy, and to the best of our knowledge, the first case to be treated with an over-the-scope clip (OTSC).…”