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Kaur M, Chaudhary N, Kapatia G. Breast lump: "Keep me in your differentials". Cytojournal 2023; 20:13. [PMID: 37405307 PMCID: PMC10316205 DOI: 10.25259/cytojournal_12_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/20/2022] [Indexed: 07/06/2023] Open
Affiliation(s)
- Manjit Kaur
- Department of Pathology, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Neelam Chaudhary
- Department of Pathology, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Gargi Kapatia
- Department of Pathology, All India Institute of Medical Sciences, Bathinda, Punjab, India
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Porter RS, Arca MJ, Weinberg GA, Livingston MH. Breast abscess due to Actinomyces in a 14-year-old girl: First reported pediatric case. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.101813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Milentijević M, Katanić N, Aritonović-Pribaković J, Kočović A, Milosavljević J, Milosavljević M, Stefanović S, Ivković Đ. Antimicrobial treatment of Acinetobacter neuii invasive infections: A systematic review. PRAXIS MEDICA 2020. [DOI: 10.5937/pramed2004025m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Aims: The objectives of this study were to find out whether and to what extent Actinomyces neuii is pathogenic to humans in terms of causing invasive infections and to ascertain the most appropriate and effective antibiotic therapy against this bacterium. Material and method: This study was designed as a systematic review article. MEDLINE, Google Scholar, SCIndex, Cochrane database of published clinical trials - Central and Clinicaltrials.gov databases were systematically searched for primary case reports or case series describing invasive infection with Actinomyces neuii. Results: A literature search identified 23 studies that met the inclusion criteria, describing cases of patients with an invasive infection caused by Actinomyces neuii. It was found that A. neuii could cause endocarditis, endophthalmitis, osteomyelitis, pleural empyema, soft tissue abscesses, neonatal sepsis, ventriculoperitoneal shunt infections and periprosthetic tissue infections. The most prescribed antibiotics for the treatment of Actinomyces neuii infections were amoxicillin and vancomycin (n = 10; 12.3%), followed by penicillin (n =9; 11.1%), gentamicin (n = 6; 7.4%), ampicillin (n = 5; 6.2%) and ceftazidime (n = 4; 4.9%). Antibiotic treatment of infections caused by A. neuii was followed by clinical improvement or complete cure of all patients, with no recorded deaths. Conclusion: A. neuii has a relevant pathogenic potential to cause invasive infections of various organs and tissues, especially in immunocompromised individuals of any age. For the treatment of mild infections caused by this bacterium, the antibiotics of choice are penicillin or amoxicillin, while vancomycin should be used to treat severe infections caused by Actinomyces neuii.
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Yang WT, Grant M. Actinomyces neuii: a case report of a rare cause of acute infective endocarditis and literature review. BMC Infect Dis 2019; 19:511. [PMID: 31182045 PMCID: PMC6558687 DOI: 10.1186/s12879-019-4149-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Infective endocarditis caused by Actinomyces spp. is extremely rare. However, cases by new species of Actinomyces have been increasingly reported due to advances in laboratory techniques, and many of these species do not cause classic presentations of actinomycosis. Actinomyces neuii is reported to have a tendency to cause endovascular infection. The course of infective endocarditis caused by Actinomyces spp. is usually indolent. CASE PRESENTATION A 61-year-old man with history of infective endocarditis, end stage renal disease, and monoclonal gammopathy was admitted for an abrupt fever, confusion, dysarthria, and facial droop after hemodialysis. Echocardiogram showed vegetations on both the aortic and mitral valves. Two sets of blood culture grew A. neuii. Brain MRI showed multiple bilateral cerebral infarcts consistent with septic emboli. The patient recovered after valvular surgery and prolonged intravenous and oral antibiotic therapy. CONCLUSIONS This case illustrates an unusually acute presentation of A. neuii infective endocarditis. As with other Gram-positive bacilli, Actinomyces spp. isolates are often regarded as a result of contamination. One should keep it in mind as a cause of infective endocarditis in vulnerable patient populations.
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Affiliation(s)
- Wei-Teng Yang
- Department of Internal Medicine, Yale New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, USA.
| | - Matthew Grant
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, PO Box 208022, New Haven, CT, 06510, USA
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Leenstra B, Schaap C, Bessems M, Renders N, Bosscha K. Primary Actinomycosis in the breast caused by Actinomyces neuii. A report of 2 cases. IDCases 2017; 8:70-72. [PMID: 28462153 PMCID: PMC5406516 DOI: 10.1016/j.idcr.2017.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 11/25/2022] Open
Abstract
Actinomycosis is a slowly progressive infection caused by anaerobic bacteria, primarily from the genus Actinomyces. Primary actinomycosis of the breast is rare and presents as a mass like density which can mimic malignancy. Mammography, ultrasonography and histopathologic examination is required for diagnosis. Treatment should consist of high doses of antibacterials for a prolonged period of time and possibly surgical drainage. Primary actinomycosis infections are commonly caused by A. israelii. Actinomyces neuii is a less common cause of classical actinomycosis. We present two cases of primary actinomycosis of the breast in two female patients caused by A. neuii.
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Affiliation(s)
- B.S. Leenstra
- Corresponding author at: Henri Dunantstraat 1, 5223 GZ, Den Bosch, The Netherlands.
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Zelyas N, Gee S, Nilsson B, Bennett T, Rennie R. Infections Caused by Actinomyces neuii: A Case Series and Review of an Unusual Bacterium. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2016; 2016:6017605. [PMID: 27366175 PMCID: PMC4904567 DOI: 10.1155/2016/6017605] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 12/28/2015] [Indexed: 12/16/2022]
Abstract
Background. Actinomyces neuii is a Gram-positive bacillus rarely implicated in human infections. However, its occurrence is being increasingly recognized with the use of improved identification systems. Objective. To analyse A. neuii infections in Alberta, Canada, and review the literature regarding this unusual pathogen. Methods. Cases of A. neuii were identified in 2013-2014 in Alberta. Samples were cultured aerobically and anaerobically. A predominant catalase positive Gram-positive coryneform bacillus with no branching was isolated in each case. Testing was initially done with API-CORYNE® (bioMérieux) and isolates were sent to the Provincial Laboratory for Public Health for further testing. Isolates' identities were confirmed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry microbial identification system (MALDI-TOF MS MIS; bioMérieux) and/or DNA sequencing. Results. Six cases of A. neuii infection were identified. All patients had soft tissue infections; typically, incision and drainage were done followed by a course of antibiotics. Agents used included cephalexin, ertapenem, ciprofloxacin, and clindamycin. All had favourable outcomes. Conclusions. While A. neuii is infrequently recognized, it can cause a diverse array of infections. Increased use of MALDI-TOF MS MIS is leading to increased detection; thus, understanding the pathogenicity of this bacterium and its typical susceptibility profile will aid clinical decision-making.
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Affiliation(s)
- Nathan Zelyas
- Provincial Laboratory for Public Health, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440-112 Street, Edmonton, AB, Canada T6G 2J2
| | - Susan Gee
- Provincial Laboratory for Public Health, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440-112 Street, Edmonton, AB, Canada T6G 2J2
| | - Barb Nilsson
- Queen Elizabeth II Hospital, 10409-98 Street, Grande Prairie, AB, Canada T8V 2E8
| | - Tracy Bennett
- Red Deer Regional Hospital, 3942-50a Avenue, Red Deer, AB, Canada T4N 4E7
| | - Robert Rennie
- Provincial Laboratory for Public Health, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440-112 Street, Edmonton, AB, Canada T6G 2J2
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Walther K, Bruder E, Goldenberger D, Mayr J, Schaad UB, Ritz N. Actinomyces neuii Isolated From a 20-Month-Old Girl With Cervical Lymphadenitis. J Pediatric Infect Dis Soc 2015; 4:e32-7. [PMID: 26407440 DOI: 10.1093/jpids/piu096] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 08/18/2014] [Indexed: 11/13/2022]
Abstract
Actinomycetes are Gram-positive bacteria that can be part of the normal human flora of the gastrointestinal, pulmonary, and genital tract. Infections are rare, slowly progressing and most commonly affect the cervicofacial region. Actinomyces israelii is the most frequently isolated species but a number of other species may cause infection. We report the first postnatally acquired case of an actinomycosis caused by A. neuii in a child. We also provide a systematic review of all published cases of A. neuii infections. In children, there is one case report of a premature infant with perinatally acquired A. neuii sepsis. In adults 21 cases have currently been reported and A. neuii infection was associated with endophthalmitis after eye surgery, foreign material-associated infection and abscess formation in the inguinal, axillary, and mammary area. Our case highlights that a A. neuii infection is also a potential differential diagnosis in children with chronic lymphadenitis.
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Affiliation(s)
| | | | | | - Johannes Mayr
- Department of Paediatric Surgery, University Children's Hospital Basel
| | | | - Nicole Ritz
- Paediatric Infectious Diseases Unit Paediatric Infectious Diseases Unit, Royal Children's Hospital Melbourne, Australia
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Abstract
Actinomycosis is a chronic infection caused by Actinomyces species characterized by abscess formation, tissue fibrosis, and draining sinuses. The spectrum of infections caused by Actinomyces species ranges from classical invasive actinomycosis to a less invasive form of superficial skin and soft tissue infection. We present a review detailing all Actinomyces species isolated from breast infections in NHS Lothian between 2005 and 2013, Actinomyces species isolated from breast infections referred to the United Kingdom Anaerobe Reference Unit between 1988 and 2014, and cases describing Actinomyces breast infections published in the medical literature since 1994. Actinomyces species are fastidious organisms which can be difficult to identify and are likely to be underascertained as a cause of breast infections. Due to improved diagnostic methods, they are increasingly associated with chronic, recurrent breast infections and may play a more significant role in these infections than has previously been appreciated.
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First report of Actinomyces europaeus bacteraemia result from a breast abscess in a 53-year-old man. New Microbes New Infect 2015; 7:21-2. [PMID: 26110063 PMCID: PMC4477111 DOI: 10.1016/j.nmni.2015.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/19/2015] [Accepted: 05/04/2015] [Indexed: 12/18/2022] Open
Abstract
This is the first report of Actinomyces europaeus bacteraemia in a 53-year-old man. The bacteraemia was the result of a breast abscess. Identification was established by matrix-assisted desorption ionization-time of flight mass spectrometry and confirmed by 16S rRNA gene sequencing. The patient was treated with surgical drainage and penicillin for 4 weeks; the patient did not experience any relapse during 6 months of follow-up.
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Abstract
Actinomyces israelii has long been recognized as a causative agent of actinomycosis. During the past 3 decades, a large number of novel Actinomyces species have been described. Their detection and identification in clinical microbiology laboratories and recognition as pathogens in clinical settings can be challenging. With the introduction of advanced molecular methods, knowledge about their clinical relevance is gradually increasing, and the spectrum of diseases associated with Actinomyces and Actinomyces-like organisms is widening accordingly; for example, Actinomyces meyeri, Actinomyces neuii, and Actinomyces turicensis as well as Actinotignum (formerly Actinobaculum) schaalii are emerging as important causes of specific infections at various body sites. In the present review, we have gathered this information to provide a comprehensive and microbiologically consistent overview of the significance of Actinomyces and some closely related taxa in human infections.
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von Graevenitz A. Actinomyces neuii: review of an unusual infectious agent. Infection 2011; 39:97-100. [PMID: 21340579 DOI: 10.1007/s15010-011-0088-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Accepted: 01/20/2011] [Indexed: 12/20/2022]
Abstract
Actinomyces neuii, a species first described in 1994, has proven to be an exception in this genus on account of its aerobic growth, microscopic morphology (no branching), and the types and location of infections. Abscesses and infected atheromas are the most frequent types of infections, followed by infected skin structures, endophthalmitis, and bacteremias, including endocarditis. They are most likely of endogenous origin. To date, approximately 100 cases have been recorded in the literature. Intra-abdominal and intrathoracic infections, however, have not yet been described, and cases of classical actinomycosis seem to be extremely rare. Prognosis has generally been good with antibiotic and/or surgical treatment. Susceptibility to antibiotics has paralleled that of other Actinomyces spp.
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Affiliation(s)
- Alexander von Graevenitz
- Institute of Medical Microbiology, University of Zurich, Gloriastrasse 32, 8006 Zurich, Switzerland.
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