Primary cutaneous actinomycosis

A first case of prosthetic joint infection with Actinomyces radingae

Prosthetic joint infection is a common clinical orthopedic problem but infections caused by Actinomyces species have been rarely reported. An increasing number of reports identifying Actinomyces in cases of prosthetic joint infection suggest it may be an emerging pathogen. We describe here the first known case of a prosthetic joint infection caused by Actinomyces radingae.

Actinomycosis of the Lower Lip: Report of a Case

Actinomycosis is usually a chronic infectious disease caused by Actinomyces species, which are anaerobic Gram-positive bacteria that normally colonize the human oral cavity and digestive and urogenital tracts. Although this lesion often occurs on soft tissue around the mandible, cases localized in the lip are very uncommon. We encountered a patient with actinomycosis in the lower lip. A 76-year-old woman with a 5-mm submucosal nodule of the lower lip was referred to our hospital from a dental clinic. The clinical diagnosis was a benign submucosal tumor. Total excision and histological examination were conducted. No oral antibiotic therapy was prescribed. The histological diagnosis was actinomycosis. The postoperative course was uneventful with no signs of recurrence during the 6 months after surgery.

Primary cutaneous actinomycosis:a case report

Actinomycosis is a subacute or chronic suppurative bacterial infection caused by filamentous gram positive, anaerobic to microaerophilic non acid fast bacilli primarily of the genus Actinomyces that normally colonize the mouth, colon and vagina. Primary cutaneous actinomycosis is a rare entity and is generally associated with trauma. We report a case of primary cutaneous actinomycosis of the back and left axilla in a 32-year-old female patient with no suggestive history of trauma.The diagnosis was suggested by the characteristic lesions with multiple discharging sinuses draining sero-sanguinous fluid scattered all over the lesions. Gram positive bacilli with plenty of pus cells were demonstrated in the direct examination of the discharging pus. Diagnosis was confirmed by isolation of the organisms by anaerobic culture giving typical molar tooth colonies. Final confirmation was done by histopathological examination.

Cutaneous actinomycosis associated with anti-TNF-alpha therapy: report of two cases

Increased susceptibility to infections is among the main safety concerns raised by anti-TNF-α agents. We describe two cases of cutaneous actinomycosis in patients undergoing anti-TNF-α therapy: a 49-year-old female treated with etanercept for rheumatoid arthritis and a 57-year-old female treated with infliximab for psoriasis. Both patients had discharge with the intermittent presence of sulfur granules occurring at the site of previous surgical wounds. Bacteriological culture demonstrated Actinomyces. Since in both cases laboratory findings and medical imaging ruled out visceral actinomycosis, oral antibiotics were introduced without discontinuing anti-TNF-α. The first patient did not relapse after 2 years. The second one did and received a second course of antibiotics combined with transient interruption of the anti-TNF-α therapy. The risk of developing actinomycosis is reported to be similar in immunocompetent and immunocompromised patients, however cases of cutaneous actinomycosis occurring during anti-TNF-α therapy need to be recognized and may be under-reported.

Penile actinomycosis clinically diagnosed as an epidermal cyst: a case report

A 27-year-old man presented at our hospital with a 1.5 cm, spherical, soft and movable subcutaneous mass at the mid portion of the ventral aspect of the penile shaft. The possibility of an epidermal cyst was considered and a simple resection was performed. Histologically, the lesion was a unilocular cyst without an epithelial lining, containing eosinophilic necrotic material and a few dispersed scalloped sheets of actinomycotic granules. The centre of the largest granular body demonstrated many fragments of foreign substance. The patient was treated successfully with combined antibiotic therapy.

Actinomycosis of the upper lip

Actinomycotic infections are known to have an association with difficulties in diagnosis and treatment. These infections usually involve the head, neck, thorax, and abdomen. Actinomycosis of the upper lip is a rare condition and an important one as well, because it can imitate other diseases. As the initial impression, it can easily be mistaken for a mucocele, venous lake, or benign neoplasm. An 82-year-old man presented with an asymptomatic normal skin colored nodule on the upper lip. Histopathologic findings showed an abscess and sulfur granules in the dermis. Gram staining results showed a mesh of branching rods. In this report, we present an unusual case of actinomycosis of the upper lip and discuss its characteristics and therapeutic modalities.

Primary cutaneous actinomycosis caused by Actinomyces bovis in a patient with common variable immunodeficiency

Actinomycosis is a chronic, suppurative granulomatous disease caused by the genus Actinomyces. This report is an interesting case of primary cutaneous actinomycosis (PCA) in a patient with common variable immunodeficiency (CVI) affecting the fingernails. The patient was successfully treated with penicillin G, cefazolin and metronidazole as well as surgical debridement of the infected tissues. In a 4-year follow-up period, no recurrence was observed. Primary cutaneous actinomycosis is a rare disease and the diagnosis needs a high index of clinical suspicion with attention to the history of skin implantation of the organism.