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Joshi AL, Pradeep I, Nigam JS, Arora AJ, Ramamourthy B. Regular resident becomes aggressive enemy: Diagnosed on cytology. Cytopathology 2024; 35:292-295. [PMID: 37916668 DOI: 10.1111/cyt.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/10/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023]
Abstract
Actinomycosis, an oral cavity commensal, causes cervicofacial infection in patients associated with an immunosuppression state and local mucosal injuries. Bone involvement by this commensal is rare. In the present case, we report a case of left peri mandibular soft tissue, soft to firm, tender swelling in a 39-year-old immunocompetent male diagnosed as Actinomycosis infection on fine needle aspiration cytology (FNAC) and cell block preparation.
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Affiliation(s)
| | - Immanuel Pradeep
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Jitendra Singh Nigam
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | | | - Balaji Ramamourthy
- Department of ENT, All India Institute of Medical Sciences, Bibinagar, Telangana, India
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Periapical Actinomycosis: A Rare Subdivision of Cervicofacial Actinomycosis, Review of the Literature, and a Case Report. Case Rep Dent 2022; 2022:7323268. [PMID: 35706907 PMCID: PMC9192198 DOI: 10.1155/2022/7323268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 11/19/2022] Open
Abstract
Background Periapical actinomycosis, which is reckoned as a subgroup of cervicofacial actinomycosis, is an uncommon, more indolent, less invasive, and limited type of actinomycosis infection. However, it can be considerably underreported due to the low number of periapical surgical specimens that are submitted for histopathological analysis after excision of the lesion with the preliminary diagnosis of typical periapical infections. It is believed that during root canal treatment, the organisms are displaced from the oral cavity into the periapical regions as a result of failure to establish aseptic techniques which can further result in actinomycosis infections and, in rare instances, lead to more severe events and can even be life-threatening. Case Presentation. We intend to report a case of periapical actinomycosis in a 34-year-old female who presented with the chief complaint of pain and slight mobility of the mandibular right second premolar and first molar with no significant issues in the patient's medical history. Initial orthopantomography revealed a uniloculated, radiolucent lesion engulfing the apices of the aforementioned teeth. An incisional biopsy was then obtained which revealed fragments of fibroconnective tissue including few crushed bone particles severely infiltrated by acute inflammatory cells and some foamy macrophages. The suppurative exudate focally surrounds colonies of filamentous bacteria as round basophilic masses with radial configuration resembling “sulfur granules.” Surgical approach consisted of curettage accompanied with peripheral ostectomy and cautious burnishing of the two involved tooth roots. Conclusion This case report emphasizes the importance of aseptic techniques during endodontic and more invasive treatments, as they can cause penetration of Actinomyces into the periapical region which in some cases can lead to more serious complications and even life-threatening situations.
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Conley W, Cox RE, Robey T. Rhinocerebral Mucormycosis Associated With Anterior Skull Base Actinomyces Osteomyelitis in a Pediatric Patient With Type 1 Diabetes. Cureus 2022; 14:e24311. [PMID: 35607550 PMCID: PMC9123382 DOI: 10.7759/cureus.24311] [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] [Accepted: 04/18/2022] [Indexed: 11/05/2022] Open
Abstract
Rhino-orbital-cerebral mucormycosis (ROCM) is a fulminant, often fatal, angioinvasive fungal infection commonly transmitted through inhalation of fungal spores and traumatic inoculation. While the literature has documented rare cases of infection in immunocompetent patients, the vast majority of case fatalities are noted in immunosuppressed populations. Common predisposing factors to infection include immunosuppressive therapies, hematologic malignancies, and most notably, uncontrolled diabetes. Actinomycosis is a subacute to chronic bacterial infection stemming from non-spore-forming anaerobic/microaerophilic bacteria of the genus Actinomyces. Infection with Actinomyces species has been documented across numerous anatomical sites; however, literature on concurrent infection with ROCM in pediatric patients is sparse. We document a case of a 17-year-old male with uncontrolled type 1 diabetes who presented to the emergency department with combined ROCM and actinomycotic infection of his anterior skull base.
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Affiliation(s)
- William Conley
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, USA
| | - Ronald E Cox
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, USA
| | - Thomas Robey
- Department of Otolaryngology-Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, USA
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Swain S. Actinomycosis in head-and-neck region – A review. MATRIX SCIENCE MEDICA 2022. [DOI: 10.4103/mtsm.mtsm_14_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Skull base infections are uncommon but can be life threatening without timely recognition. Imaging plays a crucial role because symptoms can be vague and nonlocalizing. Necrotizing otitis externa in diabetic or immunocompromised patients is the commonest cause of skull base osteomyelitis (SBO), followed by sinogenic infections and idiopathic central SBO. Multiparametric magnetic resonance (MR) and high-resolution CT are the mainstays for establishing a diagnosis and estimating disease extent, with MR being superior in ascertaining marrow and soft tissue involvement. Monitoring treatment response, of which imaging is a fundamental part, is challenging, with emerging promising imaging tools.
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Affiliation(s)
- Sriram Vaidyanathan
- Department of Radiology and Nuclear Medicine, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds LS9 7TF, UK.
| | - Ravi Kumar Lingam
- Department of Radiology, Northwick Park & Central Middlesex Hospitals, London North West University Healthcare NHS Trust, Imperial College London, Watford Road, London HA1 3UJ, UK
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Parlak HM, Akman AC, Comerdov E, Kosemehmetoglu K, Inkaya AC, Keceli HG. An Unusual Case of Early Dental Implant Failure in an Otherwise-Healthy Patient due to Actinomycosis. J ORAL IMPLANTOL 2021; 48:226-236. [PMID: 34091675 DOI: 10.1563/aaid-joi-d-20-00301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Actinomyces spp. are members of normal oral flora that may give rise to a rare disease- oral actinomycosis . Here we present a case of early implant failure associated with actinomycosis in an otherwise -healthy 43-year-old female and the treatment adopted following explantation. Clinically, one month after the implant placement, the peri-implant soft tissues were hyperplastic and associated with an excessive tissue reaction, bleeding, suppuration, deep probing depth , and implant mobility at #19 and #20 implants. Both implants were removed and all granulomatous tissues were thoroughly debrided. Histopathological examination revealed signs of acute ulcerative inflammatory reaction and Actinomyces colonies. The patient was prescribed short-term oral penicillins. After six months following explantation, the deficient bone was augmented with using a combination of absorbable collagen membrane, autogenous block and xenograft. The patient was followed up for one year ; and subsequently, two implants were reinserted at the same positions. The patient was followed up and no recurrences were observed. Implant failure due to actinomycosis is an extremely rare condition , and a definitive diagnosis is therefore essential for successful treatment.
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Affiliation(s)
- Hanife Merva Parlak
- Hacettepe University Faculty of Dentistry, Periodontology Department Periodontology Department Hacettepe University TURKEY Ankara 06230 Hacettepe University Faculty of Dentistry, Periodontology Department, Ankara, Turkey
| | - Abdullah C Akman
- Professor, Hacettepe University Faculty of Dentistry, Periodontology Department, Ankara, Turkey
| | - Elnur Comerdov
- Hacettepe University Faculty of Dentistry, Periodontology Department, Ankara, Turkey
| | - Kemal Kosemehmetoglu
- Associate Professor, Hacettepe Univesity Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Ahmet Cagkan Inkaya
- Lecturer, Hacettepe Univesity Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - H Gencay Keceli
- Associate Professor, Hacettepe University Faculty of Dentistry, Periodontology Department, Ankara, Turkey
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Abstract
We report a case of primary temporal bone diffuse B-cell non-Hodgkin lymphoma, which is a rare entity. A 71-year-old male with a history of dementia and hemicraniectomy presented due to 1 month of a pronounced left ulcerative mastoid lesion. Strikingly, there were no cranial nerve deficits which was unexpected due to the degree of the lesion. Initially, infectious mastoiditis was suspected based on physical examination alone. Due to the patient being a poor historian, it was difficult to determine whether this was an acute or chronic issue. Temporal bone squamous cell carcinoma, infectious mastoiditis, and actinomycosis were on the differential, but biopsies revealed non-Hodgkin lymphoma.
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Affiliation(s)
- Eytan Keidar
- Department of Otolaryngology, 21138McLaren Oakland Health System, Michigan State University, Pontiac, MI, USA
| | - Ian Bowers
- Department of Otolaryngology, 21138McLaren Oakland Health System, Michigan State University, Pontiac, MI, USA
| | - Eric Sargent
- Michigan Ear Institute, Farmington Hills, MI, USA
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Boorman S, Boone L, Weatherall K, Caldwell F. Actinomyces as a Cause of Osteomyelitis of the Nasofrontal Suture in a Gelding. J Equine Vet Sci 2020; 91:103148. [PMID: 32684273 DOI: 10.1016/j.jevs.2020.103148] [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: 02/16/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
A 7-year-old American Quarter Horse gelding was referred to the JT Vaughan Large Animal Teaching Hospital at Auburn University, College of Veterinary Medicine, for an investigation of a recurrent swelling of the nasofrontal region. Computed tomography examination of the skull was most consistent with a sequestrum of the left nasofrontal suture with associated focal osteomyelitis and left conchofrontal sinusitis. Surgery to remove the sequestrum, debride the devitalized bone, and flush the left conchofrontal sinus was performed. A microbial culture was obtained at the time of surgery, which yielded a mixed heavy growth of an Actinomyces species. Quantitative PCR indicated a species with 93% resemblance to Actinomyces funkei. A treatment course of two weeks of oral chloramphenicol was prescribed. At three-month follow-up, the owner reported resolution of the swelling.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Lindsey Boone
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL.
| | - Kathleen Weatherall
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
| | - Fred Caldwell
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
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