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Wang M, Xiao Q, Wang K. Empyema caused by Actinomyces odontolyticus: A case report. Medicine (Baltimore) 2024; 103:e37003. [PMID: 38306531 PMCID: PMC10843370 DOI: 10.1097/md.0000000000037003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/29/2023] [Indexed: 02/04/2024] Open
Abstract
RATIONALE Actinomyces odontolyticus causes a rare, chronic granulomatous infection that is frequently associated with immunocompromised states. A odontolyticus can cause infection in multiple organs, but empyema is rare. PATIENT CONCERNS We report a case of empyema caused by A odontolyticus. The patient was a 64-year-old man. He was admitted to the hospital with a 5-day history of fever and dyspnea. He had caries and sequelae of cerebral apoplexy. DIAGNOSES Metagenome next generation sequencing of pleural effusion was positive for A odontolyticus. Pathogen was identified by biphasic culture of pleural effusion fluid. INTERVENTIONS According to the drug sensitivity test, linezolid 0.6 g twice daily and clindamycin 0.6 g 3 times a day were administered intravenously. Thoracic drainage was initially performed, but the drainage was not sufficient. Medical thoracoscopy was performed to fully drain the pleural effusion. OUTCOMES After anti-infection and medical thoracoscopic therapy, the symptoms of this patient improved. LESSONS Microbial metagenome sequencing can find pathogens that are difficult to culture by traditional methods. Adequate drainage was the key to the treatment of empyema. Medical thoracoscopy was recommended to remove the pleural effusion and spoilage when thoracic drainage is difficult. The common clinical features of A odontolyticus include a mass or swelling, abdominal disease, dental disease, and subcutaneous abscesses. Microbial metagenome sequencing can find pathogens that are difficult to culture by traditional methods. Adequate drainage was the key to the treatment of empyema. Medical thoracoscopy was recommended to remove the pleural effusion and spoilage when thoracic drainage is difficult.
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Affiliation(s)
- Min Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qianfeng Xiao
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Kaige Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
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Kim HG, Lee HK, Park E. Abdominal Actinomycotic Abscess after Laparoscopic Sleeve Gastrectomy for Morbid Obesity: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1516. [PMID: 37763634 PMCID: PMC10534873 DOI: 10.3390/medicina59091516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/11/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023]
Abstract
Actinomycosis is a rare, chronic, suppurative, and granulomatous bacterial disease. The Actinomyces species exist as normal flora in the oropharynx, gastrointestinal tract, and the female genital tract. They are incapable of penetrating the normal mucous membranes and become pathogenic only when this barrier has been destroyed by trauma, surgery, immunosuppression, or after viscus perforation. We report the first case of an actinomycotic abscess after laparoscopic sleeve gastrectomy. A 29-year-old man underwent a laparoscopic sleeve gastrectomy with no intra-operative complications. On postoperative day 3, the patient had a fever with elevated inflammatory markers. Abdominal computerized tomography (CT) with oral water-soluble contrast media showed no extra-luminal leakage and no fluid collection adjacent to the resected stomach, other than the fluid collection in the right subhepatic space. Percutaneous drainage was attempted, but the procedure failed due to the patient's thick abdominal wall. After two weeks of weight loss of about 12 kg, percutaneous drainage was successfully performed, and A. odontolyticus was identified through pus culture. After effective abscess drainage and high-dose antibiotics, the patient's symptoms improved and the abscess pocket disappeared. We reported Actinomyces infection after gastric sleeve surgery. In the case of abscess formation after gastric sleeve surgery caused by actinomycete infection, antibiotic treatment and percutaneous drainage are effective together.
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Affiliation(s)
- Ho-Goon Kim
- Department of General Surgery, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju 61469, Republic of Korea;
| | - Ho-Kyun Lee
- Department of General Surgery, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju 61469, Republic of Korea;
| | - Eunkyu Park
- Department of General Surgery, Chonnam National University Hospital, 42, Jebong-ro, Dong-gu, Gwangju 61469, Republic of Korea
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Huang Q, Hong Z, Hong Q. Cryptococcal meningoencephalitis with Actinomyces odontolyticus sepsis: a case report and literature review. BMC Infect Dis 2023; 23:434. [PMID: 37365493 DOI: 10.1186/s12879-023-08391-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND The combined infection of actinomyces odontolyticus sepsis and cryptococcal encephalitis is rare in routine clinical practice. Thus, we presented this case report and literature review to provide clues to improve such patients' diagnoses and treatment processes. CASE PRESENTATION The main clinical manifestations of the patient were high fever and intracranial hypertension. Then, we completed the routine cerebrospinal fluid examination, biochemical detection, cytological examination, bacterial culture, and India ink staining. Firstly, the blood culture suggested actinomyces odontolyticus infection, considering the possibility of actinomyces odontolyticus sepsis and intracranial actinomyces odontolyticus infection. Accordingly, the patient was administered penicillin for treatment. Although the fever was slightly relieved, the symptoms of intracranial hypertension did not relieve. After 7 days, the characteristics of brain magnetic resonance imaging and the results of pathogenic metagenomics sequencing and cryptococcal capsular polysaccharide antigen suggested that cryptococcal infection. Based on the above results, the patient was diagnosed with a combined infection of cryptococcal meningoencephalitis and actinomyces odontolyticus sepsis. Anti-infection therapy with 'penicillin, amphotericin, and fluconazole' was provided, improving the clinical manifestations and objective indexes. CONCLUSION The combined infection of Actinomyces odontolyticus sepsis and cryptococcal encephalitis is first reported in this case report, and combined antibiotics with 'penicillin, amphotericin, and fluconazole' are effective.
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Affiliation(s)
- Qingyu Huang
- Department of Neurology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, Fujian, China
| | - Zhuquan Hong
- Department of Neurology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, Fujian, China
| | - Quanlong Hong
- Department of Neurology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, Fujian, China.
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Kumar P, Kumaresan M, Biswas R, Saxena SK. Veillonella atypica causing retropharyngeal abscess: A rare case presentation. Anaerobe 2023; 81:102712. [PMID: 36746223 DOI: 10.1016/j.anaerobe.2023.102712] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/23/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
Veillonella species are obligate anaerobes which are part of the human oral, gut and vaginal microbiota. The genus Veillonella consists of 16 characterized species. Very few infections due to Veillonella atypica have been reported till date. Here we present a case of retropharyngeal abscess due to this organism in a 55-year-old lady.
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Affiliation(s)
- Pradeep Kumar
- Department of Microbiology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605 006, India
| | - Mahalakshmi Kumaresan
- Department of Microbiology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605 006, India
| | - Rakhi Biswas
- Department of Microbiology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605 006, India.
| | - Sunil Kumar Saxena
- Department of Otorhinolaryngology, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, 605 006, India
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Yuan Y, Hou Z, Peng D, Xing Z, Wang J, Zhang S. Pulmonary Actinomyces graevenitzii Infection: Case Report and Review of the Literature. Front Med (Lausanne) 2022; 9:916817. [PMID: 35755022 PMCID: PMC9226341 DOI: 10.3389/fmed.2022.916817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Pulmonary actinomycosis (PA), a chronic indolent infection, is a diagnostic challenge. Actinomyces graevenitzii is a relatively rare Actinomyces species isolated from various clinical samples. Case Presentation A 47-year-old patient presented with a 3-month history of mucopurulent expectoration and dyspnea and a 3-day history of fever up to 39.0°C. He had dental caries and a history of alcoholism. Computed tomography (CT) images of the chest revealed a consolidation shadow in the right upper and middle lobes, with necrosis containing foci of air. Actinomyces graevenitzii was isolated from bronchoalveolar lavage fluid (BALF) culture and was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. He received treatment with intravenous piperacillin-sulbactam for 10 days and oral amoxicillin-clavulanate for 7 months. His clinical condition had considerably improved. The consolidation shadow was gradually absorbed. Conclusion Early diagnosis and treatment of pulmonary actinomycosis are crucial. Bronchoscopy plays a key role in the diagnostic process, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS) is an accurate tool for Actinomyces identification.
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Affiliation(s)
- Yuan Yuan
- Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Ziliang Hou
- Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Dan Peng
- Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Zhenchuan Xing
- Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Jinxiang Wang
- Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Shuai Zhang
- Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China
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Tu J, MacDonald M, Mansfield D. Pulmonary actinomycosis and polymicrobial empyema in a patient with ABPA and bronchocoele. Respirol Case Rep 2022; 10:e0954. [PMID: 35509978 PMCID: PMC9058088 DOI: 10.1002/rcr2.954] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/09/2022] [Accepted: 04/20/2022] [Indexed: 11/09/2022] Open
Abstract
We present a 43-year-old woman, with a history of allergic bronchopulmonary aspergillosis and a chronic bronchocoele, who was admitted to hospital with an infection of the bronchocoele, progressing to a pulmonary abscess and polymicrobial empyema, following dental extraction and regular Lactobacillus probiotic ingestion. Interval chest imaging following this procedure demonstrated worsening right upper lobe opacities and a right-sided pleural effusion. Bronchoscopies identified copious mucoid secretions and an infected bronchocoele with a right upper lobe airways impaction. Oral cavity organisms including Actinomyces odontolyticus were cultured on bronchial washings. Streptococcus mitis and Lactobacillus rhamnosus were cultured in pleural fluid. Treatment with endoscopic mucoid secretion suctioning; intercostal catheter insertion and therapeutic drainage; and antibiotic, glucocorticoid and anti-IgE therapy resulted in clinical and radiological improvement. Our case illustrates the potential pulmonary complications from oral cavity organisms following tooth extraction and probiotic use in patients with chronic lung disease associated with mucoid lesions and airways obstruction.
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Affiliation(s)
- Jacky Tu
- Monash Lung and SleepMonash Medical CentreClaytonVictoriaAustralia
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonVictoriaAustralia
| | - Martin MacDonald
- Monash Lung and SleepMonash Medical CentreClaytonVictoriaAustralia
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonVictoriaAustralia
| | - Darren Mansfield
- Monash Lung and SleepMonash Medical CentreClaytonVictoriaAustralia
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonVictoriaAustralia
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Martínez-Girón R, Pantanowitz L. Pulmonary actinomycosis: cytomorphological features. Monaldi Arch Chest Dis 2021; 92. [PMID: 34738778 DOI: 10.4081/monaldi.2021.1641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 09/22/2021] [Indexed: 11/23/2022] Open
Abstract
Pulmonary actinomycosis is an uncommon infectious disease. Although the gold standard for diagnosis is histological examination with bacterial culture of lung tissue, cytology samples offer a fast and low-cost alternate diagnostic procedure. The cytology literature on this topic is limited to mostly case reports. Therefore, the aim of this study was to review cytological material in a series of patients with a diagnosis of pulmonary actinomycosis to characterize the main cytomorphological findings. Different cytological respiratory samples including sputum smears, bronchoalveolar lavages (BALs), transthoracic or endobronchial fine needle aspiration cytology (FNAC) and cell block preparations were used for retrospective examination. For all cases patient age, gender, symptoms, and radiological chest findings were recorded. A total of 26 cytological respiratory samples (14 sputum smears, 9 FNAC, two BALs) including direct smears and 6 cell blocks from 9 patients were examined. In sputum smears the most remarkable findings were the presence of dark cotton ball masses with projections like spider legs and/or mouse tails (75% of the samples). Sulfur granules were observed in 4 (40%) of the sputum smears and within FNAC cases. Various respiratory cytology samples including sputum smears, FNAC and BALs can reveal cytomorphological findings diagnostic of pulmonary actinomycosis. Characteristic cytological findings compatible with a diagnosis of this infection include cotton ball masses and less frequently sulfur granules.
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Affiliation(s)
| | - Liron Pantanowitz
- Department of Pathology & Clinical Labs., University of Michigan, Ann Arbor, MI.
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Han M, Liu G, Chen Y, Wang D, Zhang Y. Comparative Genomics Uncovers the Genetic Diversity and Characters of Veillonella atypica and Provides Insights Into Its Potential Applications. Front Microbiol 2020; 11:1219. [PMID: 32655519 PMCID: PMC7324755 DOI: 10.3389/fmicb.2020.01219] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/13/2020] [Indexed: 11/18/2022] Open
Abstract
Veillonella atypica is a bacterium that is present in the gut and the oral cavity of mammals and plays diverse roles in different niches. A recent study demonstrated that Veillonella is highly associated with marathon running and approved that V. atypica gavage improves treadmill run time in mice, revealing that V. atypica has a high biotechnological potential in improving athlete performance. However, a comprehensive analysis of the genetic diversity, function traits, and genome editing method of V. atypica remains elusive. In the present study, we conducted a systemically comparative analysis of the genetic datasets of nine V. atypica strains. The pan-genome of V. atypica consisted of 2,065 homologous clusters and exhibited an open pan-genome structure. A phylogenetic analysis of V. atypica with two different categories revealed that V. atypica OK5 was the most distant from the other eight V. atypica strains. A total of 43 orthologous genes were identified as CAZyme genes and grouped into 23 CAZyme families. The CAZyme components derived from accessory clusters contributed to the differences in the ability of the nine V. atypica strains to utilize carbohydrates. An integrated analysis of the metabolic pathways of V. atypica suggested that V. atypica strains harbored vancomycin resistance and were involved in several biosynthesis pathways of secondary metabolites. The V. atypica strains harbored four main Cas proteins, namely, CAS-Type IIIA, CAS-Type IIA, CAS-Type IIC, and CAS-Type IIID. This pilot study provides an in-depth understanding of and a fundamental knowledge about the biology of V. atypica that allow the possibility to increase the biotechnological potential of this bacterium.
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Affiliation(s)
- Maozhen Han
- School of Life Sciences, Anhui Medical University, Hefei, China
| | - Gang Liu
- School of Life Sciences, Anhui Medical University, Hefei, China
| | - Yajun Chen
- School of Life Sciences, Hefei Normal University, Hefei, China
| | - Dong Wang
- School of Life Sciences, Hefei Normal University, Hefei, China
| | - Yan Zhang
- School of Life Sciences, Hefei Normal University, Hefei, China
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