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Zhang Y, Lo KL, Liman AN, Feng XP, Ye W. Tongue-Coating Microbial and Metabolic Characteristics in Halitosis. J Dent Res 2024:220345241230067. [PMID: 38623900 DOI: 10.1177/00220345241230067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Halitosis is a common oral condition, which leads to social embarrassment and affects quality of life. Cumulative evidence has suggested the association of tongue-coating microbiome with the development of intraoral halitosis. The dynamic variations of tongue-coating microbiota and metabolites in halitosis have not been fully elucidated. Therefore, the present study aimed to determine the tongue-coating microbial and metabolic characteristics in halitosis subjects without other oral diseases using metagenomics and metabolomics analysis. The participants underwent oral examination, halitosis assessment, and tongue-coating sample collection for the microbiome and metabolome analysis. It was found that the microbiota richness and diversity were significantly elevated in the halitosis group. Furthermore, species from Actinomyces, Prevotella, Veillonella, and Solobacterium were significantly more abundant in the halitosis group. However, the Rothia and Streptococcus species exhibited opposite tendencies. Eleven Kyoto Encyclopedia of Genes and Genomes pathways were significantly enriched in the halitosis tongue coatings, including cysteine and methionine metabolism. Functional genes related to sulfur, indole, skatole, and cadaverine metabolic processes (such as serA, metH, metK and dsrAB) were identified to be more abundant in the halitosis samples. The metabolome analysis revealed that indole-3-acetic, ornithine, and L-tryptophan were significantly elevated in the halitosis samples. Furthermore, it was observed that the values of volatile sulfur compounds and indole-3-acetic abundances were positively correlated. The multiomics analysis identified the metagenomic and metabolomic characteristics to differentiate halitosis from healthy individuals using the least absolute shrinkage and selection operator logistic regression and random forest classifier. A total of 19 species and 39 metabolites were identified as features in halitosis patients, which included indole-3-acetic acid, Bacillus altitudinis, Candidatus Saccharibacteria, and Actinomyces species. In conclusion, an evident shift in microbiome and metabolome characteristics was observed in the halitosis tongue coating, which may have a potential etiological significance and provide novel insights into the mechanism for halitosis.
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Affiliation(s)
- Y Zhang
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - K L Lo
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - A N Liman
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - X P Feng
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - W Ye
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
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2
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Khabyeh-Hasbani N, Zino S, Dima E, Avital S. Appendiceal actinomycosis mimicking malignant tumor: a rare case report. Ann Med Surg (Lond) 2024; 86:1076-1079. [PMID: 38333266 PMCID: PMC10849298 DOI: 10.1097/ms9.0000000000001564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/20/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction Actinomycosis is an uncommon bacterial infection caused by Actinomyces bacteria that typically progresses slowly and leads to the formation of masses. Although it commonly affects the cervicofacial area, about 20% of cases occur in the abdominopelvic region. Because the disease can be mistaken for a tumour due to its infiltrative mass-like nature on imaging, over 90% of cases are only diagnosed following surgery and histological confirmation. This report describes a case of an appendicular mass, initially suspected to be a malignant tumour, but eventually diagnosed as appendiceal actinomycosis. Presentation of case Upon initial presentation, a 53-year-old woman with type II diabetes mellitus and no prior surgical history, displayed abnormal appendiceal uptake during a PET-computed tomography (CT) scan conducted for a suspected spinal tumour. Colonoscopy did not indicate any notable observations, and the patient chose to defer immediate action. Several months later, a CT scan revealed an increased mass-like appearance of the appendix compared to the previous PET-CT scan. After multidisciplinary discussions, a right laparoscopic hemicolectomy was recommended due to suspected malignancy. However, histological staining on microscopy confirmed actinomycosis originating from the appendix. Discussion Chronic appendicitis with radiologic features similar to appendiceal carcinoma, or abdominal masses located in the ileocecal area, in patients with or without a previous surgical history should raise suspicion of actinomycosis. Conclusion Appendiceal actinomycosis should be considered in the differential diagnosis in the aetiology of chronic appendicitis mimicking appendiceal carcinoma. Awareness and accurate diagnosis of appendiceal actinomycosis can prevent unnecessary extended surgery as was performed in this case.
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Affiliation(s)
- Nathan Khabyeh-Hasbani
- Sackler School of Medicine, Tel Aviv University, Ramat Aviv
- Department of General Surgery, Meir Medical Center, Kfar Saba
| | - Sivan Zino
- Department of General Surgery, Meir Medical Center, Kfar Saba
| | - Elena Dima
- Department of Pathology, Maccabi Healthcare System
| | - Shmuel Avital
- Sackler School of Medicine, Tel Aviv University, Ramat Aviv
- Department of General Surgery, Meir Medical Center, Kfar Saba
- Department of Surgery, Assuta Medical Center, Tel Aviv, Israel
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3
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Nieves-Velez C, Rivera-Gonzalez G, Antony S. Actinomyces-induced Osteomyelitis of the Mandible - A Rare Disease. Infect Disord Drug Targets 2024; 24:IDDT-EPUB-138167. [PMID: 38299277 DOI: 10.2174/0118715265275102231217155015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/08/2023] [Accepted: 11/23/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Actinomyces species are commensal oral cavity flora that can cause jaw osteomyelitis. Osteomyelitis of the jaw by Actinomyces is rare, and its presentation can be confused with many different pathologies. CASE PRESENTATION This is the case of a 61-year-old female with breast cancer and on chemotherapy as well as non-invasive carcinoma of the tongue who initially presented to the dentist with white spots in the right mandible near the incisors associated with right mandible pain and swelling. Actinomyces-induced osteomyelitis of the mandible was diagnosed. The patient was treated with penicillin V for 6 weeks along with a course of hyperbaric oxygen therapy, which resulted in the complete resolution of the infection. CONCLUSION In summary, jaw osteomyelitis caused by Actinomyces should always be part of the differential diagnosis; as these organisms are commensal flora, the symptoms manifested are nonspecific, and such a diagnosis could be easily missed, resulting in delay of care and disease progression.
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Affiliation(s)
- Caleb Nieves-Velez
- Department of Internal Medicine, HCA Healthcare Las Palmas/Del Sol, El Paso, Texas
| | | | - Suresh Antony
- Deparment of Infectious Diseases HCA Healthcare Las Palmas/Del Sol, El Paso, Texas
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Leite PM, Chaves CF, Morgado B, Zenha H, Costa H. Surgical Management of Severe Mandibular Actinomycosis: Segmental Mandibulectomy and Fibula Free Flap for Optimal Outcomes. Cureus 2024; 16:e52212. [PMID: 38347964 PMCID: PMC10860903 DOI: 10.7759/cureus.52212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 02/15/2024] Open
Abstract
Actinomycosis is a chronic, suppurative, granulomatous bacterial infection primarily associated with Actinomyces israelii. The condition can be categorized into three distinct clinical types based on the affected anatomical region: cervicofacial, pulmonary, or abdominopelvic actinomycosis. The standard treatment for actinomycosis involves antibiotic therapy, with an empiric penicillin regimen as the first-line approach. Surgical interventions comprise curettage of the affected bone, resection of necrotic tissues, excision of existing sinus tracts, and drainage of abscesses. These procedures are considered a last resort for cases of actinomycosis unresponsive to antibiotic therapy. In this context, we present a case of severely unresponsive actinomycosis that necessitated aggressive surgical resection of the infected mandibular bone, followed by immediate reconstruction using a fibula-free flap. The outcome yielded both favorable functional and aesthetic results.
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Affiliation(s)
- Paula Maria Leite
- Plastic and Reconstructive Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Carolina F Chaves
- Plastic and Reconstructive Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
- Microsurgery and Experimental Surgery Unit, University of Aveiro, Aveiro, PRT
| | - Bruno Morgado
- Plastic and Reconstructive Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
- Faculty of Medicine and Biomedical Sciences, University of Algarve, Faro, PRT
- Microsurgery and Experimental Surgery Unit, University of Aveiro, Aveiro, PRT
| | - Horácio Zenha
- Plastic and Reconstructive Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
- Microsurgery and Experimental Surgery Unit, University of Aveiro, Aveiro, PRT
| | - Horácio Costa
- Plastic and Reconstructive Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
- Microsurgery and Experimental Surgery Unit, University of Aveiro, Aveiro, PRT
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Wasuwanich P, Szymkiewicz D, Kumari J, Vanegas Acosta D. Cervical Facial Actinomycosis Complicated by Bacteremia After 30 Years of Dental Neglect: Successful Treatment With Ceftriaxone and Metronidazole. Cureus 2024; 16:e51734. [PMID: 38318602 PMCID: PMC10839822 DOI: 10.7759/cureus.51734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 02/07/2024] Open
Abstract
Actinomycosis is an uncommon bacterial infection, caused by the Actinomyces species, and it most commonly presents as cervicofacial actinomycosis. The most common risk factors for actinomycosis are poor dental hygiene, oral surgery, maxillofacial trauma, local tissue inflammation, and diabetes. We discuss a case of a male patient in his 50s with 30 years of poor dental hygiene, complicated by tobacco use, who presented with septic shock and was found to have cervicofacial actinomycosis and bacteremia. The treatment of severe actinomycosis often involves prolonged penicillin-based antibiotic therapy. This is the first case in the literature to describe the successful treatment of cervicofacial actinomycosis and bacteremia with intravenous cefepime (later narrowed to ceftriaxone) and oral metronidazole.
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Affiliation(s)
- Paul Wasuwanich
- College of Medicine, University of Florida College of Medicine, Gainesville, USA
| | | | - Jaya Kumari
- Internal Medicine, Mehran Medical Centre, Karachi, PAK
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6
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Robertsson C, Svensäter G, Davies JR, Bay Nord A, Malmodin D, Wickström C. Synergistic metabolism of salivary MUC5B in oral commensal bacteria during early biofilm formation. Microbiol Spectr 2023; 11:e0270423. [PMID: 37855449 PMCID: PMC10715109 DOI: 10.1128/spectrum.02704-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/05/2023] [Indexed: 10/20/2023] Open
Abstract
IMPORTANCE The study of bacterial interactions and salivary-mediated regulation of early dental biofilm activity is of interest for understanding oral microbial adaptation to environmental cues and biofilm maturation. Findings in oral commensals can prove useful from the perspectives of both oral and systemic health of the host, as well as the understanding of general microbial biofilm physiology. The knowledge may provide a basis for the development of prognostic biomarkers, or development of new treatment strategies, related to oral health and disease and possibly also to other biofilm-induced conditions. The study is also an important step toward developing the methodology for similar studies in other species and/or growth conditions.
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Affiliation(s)
- Carolina Robertsson
- Department of Oral Biology, Faculty of Odontology and Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden
| | - Gunnel Svensäter
- Department of Oral Biology, Faculty of Odontology and Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden
| | - Julia R. Davies
- Department of Oral Biology, Faculty of Odontology and Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden
| | - Anders Bay Nord
- Swedish NMR Centre, Gothenburg University, Gothenburg, Sweden
| | - Daniel Malmodin
- Swedish NMR Centre, Gothenburg University, Gothenburg, Sweden
| | - Claes Wickström
- Department of Oral Biology, Faculty of Odontology and Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden
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Del Fabro G, Volpi S, Fumarola B, Migliorati M, Bertelli D, Signorini L, Matteelli A, Meschiari M. Actinomyces spp. Prosthetic Vascular Graft Infection (PVGI): A Multicenter Case-Series and Narrative Review of the Literature. Microorganisms 2023; 11:2931. [PMID: 38138076 PMCID: PMC10745418 DOI: 10.3390/microorganisms11122931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/26/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Actinomycosis represents a challenging and under-reported complication of vascular surgery. Optimal management of Actinomyces spp. prosthetic vascular graft infection (PVGI) is highly uncertain because of the paucity of reports on this disease. METHODS We conducted a retrospective case-series of Actinomyces-PVGI that occurred in the last five years in two major university hospitals in northern Italy. We searched for previously published cases in the scientific literature. RESULTS We report five original cases of Actinomyces spp. prosthetic vascular graft infection following aortic aneurysm repair. Our literature review retrieved eight similar cases. Most patients were immunocompetent males. Most infections were polymicrobial (11/13 cases), with a prevalence of A. odontolyticus involvement (3/13 cases were associated with. Salmonella spp. infection). All cases had a late presentation (≥4 months from graft placement), with 61% associated with an aorto-enteric fistula. All patients received antibiotic therapy, but the duration was highly heterogeneous (from two weeks to life-long antibiotics). The patients without surgical revision experienced septic recurrences (2/13), permanent dysfunction (1/13), or a fatal outcome (2/13), while of the remainder who underwent vascular graft explant, six recovered completely and one developed a periprosthetic abscess. In two cases follow-up was not available. CONCLUSIONS This case-series aims to raise the diagnostic suspicion and to describe the current management of Actinomyces-PVGIs. We highlight a high heterogeneity in antibiotic duration, choice of the antibiotic regimen, and surgical management. Higher reporting rate is advisable to produce better evidence and optimize management of this rare complication of vascular surgery.
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Affiliation(s)
- Giovanni Del Fabro
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Sara Volpi
- Clinic of Infectious Diseases, University Hospital of Modena, 41124 Modena, Italy
| | - Benedetta Fumarola
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Manuela Migliorati
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Davide Bertelli
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Liana Signorini
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Alberto Matteelli
- Department of Infectious Diseases, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy
| | - Marianna Meschiari
- Clinic of Infectious Diseases, University Hospital of Modena, 41124 Modena, Italy
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8
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Stewart CE, McCafferty A, Sherertz R. Tannerella forsythia, Fusobacterium nucleatum, and Suspected Actinomyces Causing Massive Empyema: A Case Report. Cureus 2023; 15:e48117. [PMID: 38046736 PMCID: PMC10691742 DOI: 10.7759/cureus.48117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
This report presents the case of a polymicrobial empyema due to Fusobacterium nucleatum, Tannerella forsythia, and suspected Actinomyces spp., presenting as several weeks of progressive shortness of breath and malaise. The patient had many risk factors for a lower respiratory tract infection, including chronic alcohol abuse, a flu-like illness months prior, and a recent invasive dental procedure. An admission CT scan showed a large right pleural effusion. Blood cultures were negative, but an aspirate from the pleural effusion showed abundant gram-positive rods that did not grow aerobically. Subsequent anaerobic cultures at a reference laboratory grew Tannerella forsythia and Fusobacterium nucleatum. This report will review the diagnostic difficulties associated with anaerobic causes of empyema in general and the specific organisms implicated in this case.
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Affiliation(s)
- Courtney E Stewart
- Department of Internal Medicine, Grand Strand Medical Center, Myrtle Beach, USA
| | - Allison McCafferty
- Internal Medicine, Edward Via College of Osteopathic Medicine-Carolinas Campus, Spartanburg, USA
| | - Robert Sherertz
- Department of Internal Medicine, Grand Strand Medical Center, Myrtle Beach, USA
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Bohara S, Khadka M, Bhat PS, Syangtang P, Karki B, Shrestha B, Acharya SA, Khetan K, Rayamajhi J, Rawal SB. Appendicular actinomycosis: The first reported case of an uncommon finding of a common ailment from Nepal. Clin Case Rep 2023; 11:e7996. [PMID: 37786458 PMCID: PMC10541570 DOI: 10.1002/ccr3.7996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023] Open
Abstract
Key Clinical Message Actinomycosis is a rare cause of appendicitis with an incidence of 0.3-1 incident per year per 100,000 people. A significant preoperative diagnostic challenge exists and is usually diagnosed incidentally on histopathological examination. Abstract Appendicular actinomycosis, a rare, chronic granulomatous infection caused by actinomyces species, holds a significant preoperative diagnostic summons and is often diagnosed serendipitously during the regular histopathological examination. Herein, we present a case of a 36-year-old female who presented with features suggestive of acute appendicitis, underwent laparoscopic appendicectomy, and was diagnosed with appendicular actinomycosis from the histopathological examination.
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Affiliation(s)
- Sujan Bohara
- Department of Cardiovascular SurgerySahid Gangalal National Heart CentreKathmanduNepal
| | - Manoj Khadka
- Department of SurgeryNepalese Army Institute of Health ScienceKathmanduNepal
| | - Pawan Singh Bhat
- Department of General and Gastrointestinal SurgeryNepal MedicitiLalitpurNepal
| | - Prajwal Syangtang
- Department of SurgeryNepalese Army Institute of Health ScienceKathmanduNepal
| | - Badal Karki
- Department of General SurgeryMadan Bhandari Hospital, and Trauma CenterUrlabariNepal
| | - Bhagawan Shrestha
- Department of SurgeryNepalese Army Institute of Health ScienceKathmanduNepal
| | | | - Khusbhu Khetan
- Department of Laboratory medicine and pathologyNepal MedicitiLalitpurNepal
| | - Jyoti Rayamajhi
- Department of General and Gastrointestinal SurgeryNepal MedicitiLalitpurNepal
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Ioannidis O, Symeonidis S, Ouzounidis N, Foutsitzis V, Anestiadou E, Christidis P, Loutzidou L, Fesatidou V, Kerasidou O, Tsalis K, Aggelopoulos S. Two case reports of mesenteric and retroperitoneal actinomycosis and a narrative review of the relevant literature. Med Pharm Rep 2023; 96:441-446. [PMID: 37970198 PMCID: PMC10642741 DOI: 10.15386/mpr-2073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 11/13/2022] [Accepted: 01/22/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction Actinomycosis is an uncommon subacute or chronic suppurative bacterial granulomatous infectious disease with clinical heterogeneity. The majority of actinomycosis cases were of extra-abdominal origin, with oro-cervico-facial cases representing 55%, abdominopelvic representing 20%, and thoracic representing 15% of total reports. Currently, abdominal actinomycosis incidence is approximately 1 case per 119,000 people, being found three times more frequently among males. We report two rare clinical presentations of abdominal actinomycosis affecting the mesentery and the retroperitoneum, respectively. Case Report 1 A 58-year-old Caucasian male presented to our clinic with abdominal pain in the right upper quadrant. Pre-operative evaluation, although inconclusive, showed a mesocolic mass infiltrating the right and transverse colon. The patient underwent exploratory laparotomy. After partial resection of the mass, the histopathology report demonstrated mesenteric actinomycosis. Case Report 2 A 40-year-old Caucasian male presented to our clinic complaining about a mucopurulent material from an orifice at the right inguinal region. After appropriate work-up, a large abdominopelvic, stellate mass (75 x 22.8 mm) in the retroperitoneum was revealed. Surgery along with the appropriate antibiotics was used to treat the patient. Conclusion Preoperative suspicion and diagnosis of actinomycosis are very challenging, with a high rate of misdiagnosis often resulting in delayed treatment. Our case reports highlight that abdominal actinomycosis should always be part of differential diagnosis, especially when there is involvement of multiple organs. The gold standard treatment of actinomycosis is surgical excision with prolonged antibiotic treatment.
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Affiliation(s)
- Orestis Ioannidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Savvas Symeonidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Nikolaos Ouzounidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Vasilis Foutsitzis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Elissavet Anestiadou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Panagiotis Christidis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Lydia Loutzidou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Vasiliki Fesatidou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Ourania Kerasidou
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Tsalis
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Stamatios Aggelopoulos
- 4 Academic Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
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11
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Muacevic A, Adler JR, Al Ahmadi B. Disseminated Intra-abdominal Actinomycosis Mimicking Colorectal Carcinoma With Diffuse Intra-abdominal Carcinomatosis: A Case Report. Cureus 2022; 14:e32582. [PMID: 36654545 PMCID: PMC9840753 DOI: 10.7759/cureus.32582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Actinomycosis is a rare opportunistic bacterial infection. It most commonly affects the cervicofacial area and is less common in the gastrointestinal area. Because of the ambiguous clinical pictures, there is a low preoperative diagnosis rate and a high rate of misdiagnoses. In this case report, we have an unusual presentation of disseminated abdominal actinomycosis in a diabetic male patient with no previous history of surgery or trauma. He presented with abdominal pain for two years. Abdominal imaging showed rectal wall thickening with adhesion and attachment to the bladder, and small bowel with omental and peritoneal deposits, mimicking colorectal cancer with abdominal carcinomatosis. Histopathological examination, however, revealed actinomyces infection with no evidence of malignancy. In such cases, the recovery rate with antibiotic therapy is very high in conjunction with surgical resection.
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12
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Diaz A, Cyberski T, Singh A, Fenton D, Cipriani NA, Lusardi JJ, Corey JP, Blair EA. Laryngeal and pharyngeal actinomycosis: a systematic review and report of 3 cases. Am J Otolaryngol 2022; 43:103609. [PMID: 36029619 DOI: 10.1016/j.amjoto.2022.103609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Actinomycosis is a granulomatous infection that rarely involves the larynx or pharynx. Three cases of actinomycosis of the larynx or pharynx from our institution were reviewed and a systematic literature review was performed to better define surgical management, antibiotic therapy, risk factors, and incidence of recurrence or complications. MATERIALS AND METHODS PubMed/Medline, Cochrane, Embase, and Google Scholar were searched on November 30, 2021 using the terms "laryngeal actinomycosis", "pharyngeal actinomycosis", "actinomycosis AND larynx", and "actinomycosis AND pharynx." Articles which did not describe appropriate sites or were non-English were excluded. Results were collected for demographic information, site(s) of infection, comorbidities, lesion characteristics and treatments. RESULTS Along with three cases reported from our institution, 40 unique cases were reviewed from 37 studies for a total of 43 patients (Table 1). 34 (81.0 %) of the patients were male with the highest incidence of infection in the seventh decade (54.8 %). The most common site for the infection was the larynx (69.0 %) followed by the pharynx (16.7 %). Risk factors included a history of radiation therapy, immunosuppression, inhalational irritant, and diabetes (Table 3). The duration of antibiotic therapy varied greatly, from one month to one year and total follow up ranged from 1 month to 2.5 years (Table 1). CONCLUSIONS A comprehensive review of the literature on pharyngolaryngeal actinomycosis shows that this infection has increased prevalence within the head and neck cancer patient population. Similar to cervicofacial actinomycosis, these atypical sites have shown favorable responses to extended antibiotic therapy and generally do not require aggressive surgical management.
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Affiliation(s)
- Ashley Diaz
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Thomas Cyberski
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Armaan Singh
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - David Fenton
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Nicole A Cipriani
- Department of Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Jonathan J Lusardi
- Department of Otolaryngology - Head and Neck Surgery, Mercy Medical Center, St. Louis, MO, USA
| | - Jacquelynne P Corey
- Department of Surgery, Section of Otolaryngology, University of Chicago Medicine, Chicago, IL, USA
| | - Elizabeth A Blair
- Department of Surgery, Section of Otolaryngology, University of Chicago Medicine, Chicago, IL, USA.
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13
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Tan Y, Shan Y, Zheng R, Liu R, Sun C. Characterization of a Deep-Sea Actinobacterium Strain Uncovers Its Prominent Capability of Utilizing Taurine and Polyvinyl Alcohol. Front Microbiol 2022; 13:868728. [PMID: 35677903 PMCID: PMC9169050 DOI: 10.3389/fmicb.2022.868728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/17/2022] [Indexed: 11/13/2022] Open
Abstract
Actinobacteria represent a large group of important prokaryotes with great application potentials and widely distribute in diverse natural environments including the ocean. However, compared to their terrestrial cultured members, there are much less available marine Actinobacteria, especially deep-sea counterparts. Here, we cultured a bacterial strain of deep-sea actinobacterium, Marmoricola sp. TYQ2, by using a basal medium supplemented with taurine. Consistently, the growth of strain TYQ2 was significantly promoted by the supplement of taurine. Transcriptomic analysis showed that the expressions of genes encoding proteins associated with taurine metabolization and utilization as well as energy generation were evidently up-regulated when taurine was added. Moreover, strain TYQ2 was demonstrated to degrade polyvinyl alcohol (PVA) with the involvement of the redox cycle of extracellular quinol and quinone and the reduction of iron to ferrous, and strain TYQ2 could utilize the degradation products for energy production, thereby supporting bacterial growth. Overall, our experimental results demonstrate the prominent degradation capabilities of Marmoricola sp. TYQ2 toward the organics taurine and PVA.
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Affiliation(s)
- Yingqi Tan
- Chinese Academy of Sciences and Shandong Province Key Laboratory of Experimental Marine Biology and Center of Deep Sea Research, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, China.,Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China.,College of Earth Science, University of Chinese Academy of Sciences, Beijing, China.,Center of Ocean Mega-Science, Chinese Academy of Sciences, Qingdao, China
| | - Yeqi Shan
- Chinese Academy of Sciences and Shandong Province Key Laboratory of Experimental Marine Biology and Center of Deep Sea Research, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, China.,Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China.,College of Earth Science, University of Chinese Academy of Sciences, Beijing, China.,Center of Ocean Mega-Science, Chinese Academy of Sciences, Qingdao, China
| | - Rikuan Zheng
- Chinese Academy of Sciences and Shandong Province Key Laboratory of Experimental Marine Biology and Center of Deep Sea Research, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, China.,Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China.,College of Earth Science, University of Chinese Academy of Sciences, Beijing, China.,Center of Ocean Mega-Science, Chinese Academy of Sciences, Qingdao, China
| | - Rui Liu
- Chinese Academy of Sciences and Shandong Province Key Laboratory of Experimental Marine Biology and Center of Deep Sea Research, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, China.,Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China.,Center of Ocean Mega-Science, Chinese Academy of Sciences, Qingdao, China
| | - Chaomin Sun
- Chinese Academy of Sciences and Shandong Province Key Laboratory of Experimental Marine Biology and Center of Deep Sea Research, Institute of Oceanology, Chinese Academy of Sciences, Qingdao, China.,Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China.,College of Earth Science, University of Chinese Academy of Sciences, Beijing, China.,Center of Ocean Mega-Science, Chinese Academy of Sciences, Qingdao, China
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14
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Agarwal A, Kahn C, McClain K, Aaronson N. Pediatric Post-Cricoid Actinomyces. Ear Nose Throat J 2022:1455613221103078. [PMID: 35575187 DOI: 10.1177/01455613221103078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Aarti Agarwal
- Department of Otolaryngology, Head and Neck Surgery, 23217Thomas Jefferson University, Philadelphia, PA, USA
| | - Chase Kahn
- Department of Otolaryngology, Head and Neck Surgery, 23217Thomas Jefferson University, Philadelphia, PA, USA
| | - Kathleen McClain
- Division of Otolaryngology, Department of Surgery, Nemours Alfred I. DuPont Hospital for Children, Wilmington, DE, USA
| | - Nicole Aaronson
- Department of Otolaryngology, Head and Neck Surgery, 23217Thomas Jefferson University, Philadelphia, PA, USA
- Division of Otolaryngology, Department of Surgery, Nemours Alfred I. DuPont Hospital for Children, Wilmington, DE, USA
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15
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Khatib S, Al-Shyoukh A, Abdalla K, Jaber FS, Salzman G. Organizing Pneumonia Secondary to Pulmonary Actinomycosis: A Case Report and Literature Review. Cureus 2022; 14:e21133. [PMID: 35165586 PMCID: PMC8831388 DOI: 10.7759/cureus.21133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 12/01/2022] Open
Abstract
Pulmonary actinomycosis is a common clinical infection caused by Actinomyces species. Although its treatment is very effective with Intravenous (IV) antibiotics, its diagnosis is challenging and easily missed. Organizing Pneumonia (OP) can be cryptogenic or secondary to different clinical diseases. Herein, we discuss a case of acute hypoxemic respiratory failure that was found to be due to OP, secondary to pulmonary actinomycosis, with a brief review of the literature.
A 64-year-old male presented with acute hypoxemic respiratory failure two days after undergoing elective right total hip arthroplasty. Chest imaging with CT scan showed symmetric bilateral ground-glass opacities most pronounced within the upper lung lobes. The patient was treated initially with IV diuresis, steroids, and broad-spectrum antibiotics. However, his clinical status continued to worsen and his chest imaging showed worsening lung opacities. Video-assisted thoracoscopic lung biopsy (VATS) was done, and pathology results showed features of organizing pneumonia. Tissue culture confirmed Actinomyces species. The patient had clinical improvement after treatment with IV methylprednisolone and IV penicillin G. Pulmonary actinomycosis is very rarely associated with OP but this bacterial infection should always be in the differential diagnosis when OP is confirmed as the treatment is effective with IV antibiotics.
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Affiliation(s)
- Sohaib Khatib
- Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, USA
| | - Ahmad Al-Shyoukh
- Pulmonary and Critical Care Medicine, Tulane University School of Medicine, New Orleans, USA
| | - Khalid Abdalla
- Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, USA
| | - Fouad S Jaber
- Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, USA
| | - Gary Salzman
- Pulmonary and Critical Care Medicine, University of Missouri Kansas City School of Medicine, Kansas City, USA
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16
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Abstract
Actinomycosis is a rare bacterial infection that can affect almost any site in the body. Its occurrence at the nasal septum is extremely rare. We present the case of an 84-year-old diabetic woman, with a past medical history of breast cancer that came to medical attention because of progressive nasal obstruction and severe sleep apnea. Nasal endoscopy revealed a submucosal mass at the anterior nasal septum obstructing both nasal cavities and extending to the anterior hard palate. With a cancer metastasis in mind, she was submitted to surgical resection of the lesion through a Rouge-Denker approach, with the final histologic diagnosis of actinomycosis. She was then treated with a three-month cycle of amoxicillin and remains without recurrence. This case describes a rare disease that should be considered in the differential diagnosis of sinonasal lesions, especially in diabetic patients and after dental procedures.
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Affiliation(s)
- Catarina Lombo
- Otolaryngology - Head and Neck Surgery, Hospital Senhora da Oliveira de Guimarães, Guimarães, PRT
| | - Carlos Matos
- Otolaryngology - Head and Neck Surgery, Hospital Senhora da Oliveira de Guimarães, Guimarães, PRT.,Otolaryngology - Head and Neck Surgery, Hospital da Luz Guimarães, Guimarães, PRT
| | - Fausto Fernandes
- Otolaryngology - Head and Neck Surgery, Hospital da Luz Guimarães, Guimarães, PRT
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17
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Abstract
Nocardia species are difficult to identify, saprophytic, aerobic actinomycetes that are associated with high mortality rates and primarily affect immunocompromised hosts. Recently, the number ofdiagnoses of Nocardia cyriacigeorgica has grown in the United States, yet complicated clinical diagnosis and costly identification methods presume an underestimation of its presence in patients. We describe a case of brain abscess secondary to a pulmonary infection in an elderly, diabetic, Afghani man with an extensive history of chewing tobacco use.
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Affiliation(s)
- Weston D Browne
- Neuroscience and Biology, Santa Clara University, Santa Clara, USA.,Clinical Research, Dignity Health, Sacramento, USA.,Research Associate I in Neurology, University of California San Francisco, San Francisco, USA
| | | | - Mohammad J Kabbesh
- Department of Infectious Diseases, Mercy General Hospital, Sacramento, USA
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18
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Tuck N, Leatherman J, Assi M, Kallail KJ. A Case of Actinomycosis Presenting as Purulent Pericarditis with Cardiac Tamponade. Kans J Med 2021; 14:227-228. [PMID: 34540137 PMCID: PMC8415389 DOI: 10.17161/kjm.vol1415262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/28/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Nicholas Tuck
- University of Kansas School of Medicine-Wichita, Wichita, KS.,Department of Internal Medicine
| | - Jo Leatherman
- University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Maha Assi
- University of Kansas School of Medicine-Wichita, Wichita, KS.,Department of Internal Medicine.,Infectious Disease Consultants, Wichita, KS
| | - K James Kallail
- University of Kansas School of Medicine-Wichita, Wichita, KS.,Department of Internal Medicine
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19
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Rueda MS, Hefter Y, Stone B, Hahn A, Jantausch B. A Premature Infant With Neonatal Actinomyces odontolyticus Sepsis. J Pediatric Infect Dis Soc 2021; 10:533-535. [PMID: 33136166 DOI: 10.1093/jpids/piaa121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/30/2020] [Indexed: 11/14/2022]
Abstract
We describe the presentation, diagnosis and management of a premature newborn with Actinomyces odontolyticus bacteremia; this is the first case report of neonatal sepsis secondary to this bacteria. Maternal dental infection was the likely source of the pathogen. The outcome was favorable, with good response to antimicrobial therapy with ampicillin/amoxicillin.
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Affiliation(s)
- Maria S Rueda
- Department of Pediatrics, Children's National Hospital, Washington DC.,Division of Infectious Diseases, Children's National Hospital, Washington DC
| | - Yosefa Hefter
- Division of Infectious Diseases, Children's National Hospital, Washington DC
| | - Brian Stone
- Division of Neonatology, Children's National Hospital, Washington DC
| | - Andrea Hahn
- Division of Infectious Diseases, Children's National Hospital, Washington DC
| | - Barbara Jantausch
- Division of Infectious Diseases, Children's National Hospital, Washington DC
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20
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Zhu C, Lew CI, Neuhaus GF, Adpressa DA, Zakharov LN, Kaweesa EN, Plitzko B, Loesgen S. Biodiversity, Bioactivity, and Metabolites of High Desert Derived Oregonian Soil Bacteria. Chem Biodivers 2021; 18:e2100046. [PMID: 33636028 DOI: 10.1002/cbdv.202100046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/26/2021] [Indexed: 12/20/2022]
Abstract
From arid, high desert soil samples collected near Bend, Oregon, 19 unique bacteria were isolated. Each strain was identified by 16S rRNA gene sequencing, and their organic extracts were tested for antibacterial and antiproliferative activities. Noteworthy, six extracts (30 %) exhibited strong inhibition resulting in less than 50 % cell proliferation in more than one cancer cell model, tested at 10 μg/mL. Principal component analysis (PCA) of LC/MS data revealed drastic differences in the metabolic profiles found in the organic extracts of these soil bacteria. In total, fourteen potent antibacterial and/or cytotoxic metabolites were isolated via bioactivity-guided fractionation, including two new natural products: a pyrazinone containing tetrapeptide and 7-methoxy-2,3-dimethyl-4H-chromen-4-one, as well as twelve known compounds: furanonaphthoquinone I, bafilomycin C1 and D, FD-594, oligomycin A, chloramphenicol, MY12-62A, rac-sclerone, isosclerone, tunicamycin VII, tunicamycin VIII, and (6S,16S)-anthrabenzoxocinone 1.264-C.
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Affiliation(s)
- Chenxi Zhu
- Department of Chemistry, Oregon State University, Corvallis, Oregon, 97331, USA.,Whitney Laboratory for Marine Bioscience, Department of Chemistry, University of Florida, St. Augustine, Florida, 32080, USA
| | - Cassandra I Lew
- Department of Chemistry, Oregon State University, Corvallis, Oregon, 97331, USA
| | - George F Neuhaus
- Department of Chemistry, Oregon State University, Corvallis, Oregon, 97331, USA
| | - Donovon A Adpressa
- Department of Chemistry, Oregon State University, Corvallis, Oregon, 97331, USA
| | - Lev N Zakharov
- Department of Chemistry, Oregon State University, Corvallis, Oregon, 97331, USA
| | - Elizabeth N Kaweesa
- Department of Chemistry, Oregon State University, Corvallis, Oregon, 97331, USA.,Whitney Laboratory for Marine Bioscience, Department of Chemistry, University of Florida, St. Augustine, Florida, 32080, USA
| | - Birte Plitzko
- Department of Chemistry, Oregon State University, Corvallis, Oregon, 97331, USA
| | - Sandra Loesgen
- Department of Chemistry, Oregon State University, Corvallis, Oregon, 97331, USA.,Whitney Laboratory for Marine Bioscience, Department of Chemistry, University of Florida, St. Augustine, Florida, 32080, USA
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21
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Fatima I, Pretorius F, Botes S, Swanwick R. Hepatobiliary Actinomycosis, a Rare Presentation of a Rare Disease! Cureus 2020; 12:e12413. [PMID: 33542863 PMCID: PMC7847779 DOI: 10.7759/cureus.12413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Actinomycosis is a chronic granulomatous infection caused by opportunistic bacteria, Actinomyces. These bacteria lack virulence and cause disease when there is a breach in the integrity of the mucosa. Diagnosis of Actinomycosis is challenging and less than 10% of abdominopelvic cases are diagnosed preoperatively. The treatment involves prolonged course of antibiotics with or without removal of tissue. In this case report we will present a case of hepatobiliary actinomycosis which was managed by a combination of both surgical and medical treatment.
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Affiliation(s)
- Iayla Fatima
- General Surgery, St. Luke's General Hospital, Kilkenny, IRL
| | | | - Stefan Botes
- Surgery, St. Luke's General Hospital, Kilkenny, IRL
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22
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Stimac D, Jankovic D, Peric L, Anic K, Nimsky C. Intracerebral Abscess Caused by Actinomyces israelii. Cureus 2020; 12:e12058. [PMID: 33447487 PMCID: PMC7802602 DOI: 10.7759/cureus.12058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe a case of 49-years old female with a medical history of penicillin allergy, who suffered from brain infection caused by Actinomyces israelii. Therefore, the available therapy was metronidazole, ceftriaxone, and chloramphenicol. Due to a deterioration of the general and neurological condition of the patient, it was decided to perform a scratch skin test on penicillin, which was negative. After that, penicillin was administrated parenterally. The patient showed no hypersensitive reaction. Improvement was achieved. The patient underwent three subsequent surgeries due to primary and recurrent brain abscesses. There was a distinct improvement in her clinical status. Two months after the second re-surgery, the control computed tomography showed complete regression of the abscess. Brain abscess caused by an Actinomycess israelii is very resistant to medication. However, surgical evacuation significantly accelerates the healing process. A good medication therapy is crucial and in most cases the drug of choice is penicillin. We emphasize the importance of a combined approach for treating this unusual brain infection.
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Affiliation(s)
- Dinko Stimac
- Neurosurgery, Health center of Primorje - Gorski Kotar county, Rijeka, HRV
| | - Dragan Jankovic
- Neurosurgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, DEU.,Medicine, University of Zagreb, Zagreb, HRV
| | - Ljiljana Peric
- Infectious Diseases, University Hospital Osijek, Osijek, HRV
| | - Kata Anic
- Infectious Diseases, University Hospital Osijek, Osijek, HRV
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23
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Abstract
Actinomycosis is an infrequent infectious disease caused by Actinomyces species. Actinomycoses in the nasopharynx are extremely rare, especially in the Rosenmüller's fossa. This report presents a case of actinomycosis in the Rosenmüller's fossa. A 75-year-old woman presented with a 6-month history of bloody sputum. A grayish-white caseous tissue was found in the right Rosenmüller's fossa after retracting the torus tubarius. Magnetic resonance imaging showed a well-defined lesion with low-signal intensity on T1- and T2-weighted images; small low-signal areas were interspersed inside. The lesion was removed under an endoscope. Histopathological examination revealed eosinophilic, club-shaped structures surrounding a hematoxylophilic center, leading to the diagnosis of actinomycosis. The symptoms improved after 3 months of amoxicillin administration but recurred quickly. After 6 months of amoxicillin administration, the bloody sputum disappeared, and local and imaging findings were normal.
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Affiliation(s)
- Takahiro Kusaka
- Department of Otolaryngology, Head and Neck Surgery, 12833Iwate Medical University, Shiwa, Iwate, Japan
| | - Shigeru Kuwashima
- Department of Otolaryngology, Head and Neck Surgery, 12833Iwate Medical University, Shiwa, Iwate, Japan
| | - Harukazu Hiraumi
- Department of Otolaryngology, Head and Neck Surgery, 12833Iwate Medical University, Shiwa, Iwate, Japan
| | - Hiroaki Sato
- Department of Otolaryngology, Head and Neck Surgery, 12833Iwate Medical University, Shiwa, Iwate, Japan
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24
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Abstract
Actinomyces is a rare cause of prostatic abscess. Most reported cases of abdominal and pelvic actinomycosis are a consequence of invasive procedures or abdominal infections. In this report, we present a previously healthy 53-year-old man with inguinal pain, fever and dysuria who was found to have a prostate abscess, secondary to Actinomyces turicensis and Peptostreptococcus, which was removed via transurethral resection of the prostate. This case was complicated by Peptostreptococcus bacteremia and a facial abscess. The patient was treated with antibiotics and ultimately made a full recovery.
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Affiliation(s)
- Anastasia Barnes
- Infectious Diseases, State University of New York Downstate Medical Center, Brooklyn, USA
| | - Avneet Kaur
- Infectious Diseases, State University of New York Downstate Medical Center, Brooklyn, USA
| | - Michael Augenbraun
- Infectious Diseases, State University of New York Downstate Medical Center, Brooklyn, USA
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25
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Hsueh L, Kacharam S, Shah AD. A rare case of Actinomyces skin and soft tissue infection in an end-stage kidney disease patient with a review of the literature. Hemodial Int 2020; 24:E40-E45. [PMID: 32458569 DOI: 10.1111/hdi.12843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/24/2020] [Accepted: 04/29/2020] [Indexed: 12/22/2022]
Abstract
End-stage kidney disease (ESKD) patients are a commonly overlooked immunocompromised population that places them at risk for rare infections. We describe the case of a 78-year-old man with a history of ESKD managed with thrice weekly in-center hemodialysis who had a prolonged episode of left elbow pain and drainage and was eventually found to have a skin and soft tissue infection from Actinomyces radingae. We review the bacteriology of Actinomyces spp. and the experiences of other providers who have treated actinomycosis in individuals with ESKD. The anatomic sites and demographics of these individuals are heterogeneous, but they all generally require a long antibiotic course with a beta-lactam and portend to a good prognosis. High index of suspicion is needed to identify rare and atypical infections in the ESKD population.
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Affiliation(s)
- Leon Hsueh
- Department of Medicine, Veterans Affairs Medical Center, Providence, RI, USA.,Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Sumanth Kacharam
- Warren Alpert Medical School of Brown University, Providence, RI, USA.,Division of Nephrology, Medical Service, Veterans Affairs Medical Center, Providence, Rhode Island, USA
| | - Ankur D Shah
- Warren Alpert Medical School of Brown University, Providence, RI, USA.,Division of Nephrology, Medical Service, Veterans Affairs Medical Center, Providence, Rhode Island, USA
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26
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Dioguardi M, Crincoli V, Laino L, Alovisi M, Sovereto D, Lo Muzio L, Troiano G. Prevalence of Bacteria of Genus Actinomyces in Persistent Extraradicular Lesions-Systematic Review. J Clin Med 2020; 9:E457. [PMID: 32046071 DOI: 10.3390/jcm9020457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 12/14/2022] Open
Abstract
Actinomyces are anaerobic, rod-shaped, Gram-positive bacteria. They are associated with persistent extraradicular endodontic infections, with possible involvement of the soft tissues of the maxillofacial district. Many studies reported conflicting data on the presence of bacteria of the genus Actinomyces in endodontic infections. The aim of this systematic review of the literature was to determine the real prevalence of such bacteria in primary and/or secondary endodontic infections and in cases of persistence with extraradicular involvement. This systematic review was performed according to the PRISMA protocol. A search was carried out through the Scopus and PubMed databases of potentially eligible articles through the use of appropriate keywords. The literature research resulted in preliminary 2240 records which, after the elimination of overlaps and the application of inclusion and exclusion criteria, led to the inclusion of 46 articles focusing on three outcomes (primary outcome: number of teeth with the presence of a persistent extraradicular infection in which the presence of Actinomyces was ascertained; secondary outcome: number of teeth with endodontic infection in which the presence of Actinomyces was assessed; tertiary outcome: difference in the prevalence of bacteria of the genus Actinomyces between primary endodontic infections and secondary endodontic infections). Results of the meta-analysis show how bacteria of the genus Actinomyces are present in primary and secondary intraradicular infections and in those with persistence with a prevalence (ratio between teeth with actinomyces and teeth with infection) ranging from 0.091 up to 0.130 depending on the subgroups analyzed.
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27
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Łanowy P, Bichalski M, Ślusarz K, Pyka W, Dzindzio J, Błaszkowska M, Oczko-Grzesik B, Piasecki M, Jaroszewicz J. Actinomycosis - a forgotten chronic infectious disease - case report series. Przegl Epidemiol 2020; 74:644-651. [PMID: 33861031 DOI: 10.32394/pe.74.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Actinomycosis is one of the greatest 'chameleons' among infectious diseases. It may imitate inflammation, abscess or a neoplasmatic tumor. Moreover, correct diagnosis is even more challenging due to the fact that the disease takes on various forms like: cervicocephalic, abdominal, or affects the reproductive organs. In order to highlight the diagnostic difficulties of actinomycosis, we have decided to describe six cases of female patients (aged 31-73 years, mean age: 52 years) hospitalized due to actinomycosis in the Department of Infectious Diseases and Hepatology between 2014-2019. Additionally, a case of one patient was described in detail as the course of her disease was exceptionally non-specific. Only in 2 of 6 patients the primary diagnosis was correct. The four other patients were initially suspected with cancer or inflammation. Three of the patients were diagnosed with the abdominal form of actinomycosis, one - neck and head, and one presented both locations. Only histopathological examinations during invasive procedures allowed to state the final diagnosis. An adequate diagnosis was associated with a number of additional tests and delayed appropriate treatment. WBC and CRP were within normal range in all patients. Four patients completed treatment successfully after 60-192 days, one is still on therapy and one is lost to follow-up. In conclusion, common features of actinomycosis presented in this case series include predominance of female gender, abdominal localization and lack of typical symptoms. What is more, therapy with antibiotics, mainly doxycycline and beta-lactams resulted in complete regression of lesions in the majority of cases. Given the examples of our patients we believe that actinomycosis should be considered in the differential diagnosis of all abdominal tumors, especially in women. Abbreviations: WBC - white blood cells, CRP - C-reactive protein, CT - computed tomography, IUD - Intra-Uterine Device, i.v. - intravenous.
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Abstract
Introduction Tonsillitis is a very common disease in children. Understanding the microbiology and pathology of chronic tonsillitis is an important step in its management. The aim of the study was to describe the microbiological profile of core tonsillar tissue in chronic tonsillitis in children. Materials and methods Children under 16 years of age with chronic tonsillitis were recruited in the descriptive study. Children with recurrent tonsillitis and recurrent tonsillitis with obstructive symptoms were included. Children who underwent tonsillectomy for obstructive symptoms alone and those who received antibiotics for at least one month prior to surgery were excluded from the study. Dissection and the snare method of tonsillectomy were done on all children. The operated specimen was cut into two halves in a sterile container. The core of the tonsillar tissue was swabbed with two sterile cotton-tipped swabs and sent for the microbiological evaluation of aerobes and anaerobes. The tonsillar tissue was sent for a histopathological examination. Results A total of 106 children were operated for chronic tonsillitis in one year. The mean age of children included in this study was 9.4 years. The duration of symptoms due to tonsillar disease ranged from four weeks to 28 months. There were 48 males and 58 females. Recurrent tonsillitis was the most common indication for tonsillectomy in all children. A total of 301 aerobes and 171 anaerobic microorganisms were isolated from 106 children with chronic tonsillitis. The aerobic bacterial species most often isolated was Streptococcus viridans, which was present in 83 children followed by Group A, β-hemolytic Streptococci in 67 children. The anaerobic bacterial most often isolated was Peptococcus species in 49 children. Polymicrobial aerobic and anaerobic flora were present in all tonsillar specimens, yielding an average of 4.1 isolates per specimen. The histopathological examination revealed chronic tonsillitis with reactive follicular hyperplasia in all (100%) children. Actinomycosis was associated with non-specific reactive follicular hyperplasia in four specimens. Conclusion Polymicrobial aerobic and anaerobic flora are identified in deep tonsillar tissue in children with tonsillitis. The identification of bacterial isolates from the core tissue in recurrent tonsillitis could dictate the management of chronic tonsillitis. The histopathological examination of the core tissues of the tonsils helps in an accurate identification of organisms that are difficult to culture.
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Affiliation(s)
- Raja Kalaiarasi
- Otorhinolaryngology, Sri Lakshmi Narayana Institute of Medical Science, Puducherry, IND
| | | | - Chellappa Vijayakumar
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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Abstract
Pylephlebitis is a thrombophlebitis of the portal vein or its branches, which usually occurs as a complication of intra-abdominal infections that are drained by the portal vein, most commonly as a result of diverticulitis or appendicitis. Diagnosis of pylephlebitis is achieved by visualizing a portal vein thrombosis in a patient with bacteremia or a recent intra-abdominal infection. Many microorganisms have been reported to cause this infection. However, Actinomyces has never been reported before as a cause of pylephlebitis. Here, we describe a case of a 56-year-old female who had pylephlebitis that was caused by Actinomyces bacteremia and was treated with intravenous antibiotics.
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Affiliation(s)
- Omar Abughanimeh
- Internal Medicine, Kansas City School of Medicine, Kansas City, USA
| | - Mohammad Tahboub
- Internal Medicine, University of Missouri at Kansas City, Kansas City, USA
| | - Yousaf Zafar
- Internal Medicine, University of Missouri Kansas City, Kansas City, USA
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Lubomski M, Dalgliesh J, Lee K, Damodaran O, McKew G, Reddel S. Actinomyces cavernous sinus infection: a case and systematic literature review. Pract Neurol 2018; 18:373-377. [PMID: 29650638 DOI: 10.1136/practneurol-2017-001844] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 03/09/2018] [Accepted: 04/02/2018] [Indexed: 01/03/2023]
Abstract
A 63-year-old man presented with a 2-month history of progressive right-sided exophthalmos, painful ophthalmoplegia and fevers. As more features developed, he was diagnosed with giant cell arteritis, then Tolosa-Hunt syndrome, and transiently responded to corticosteroids. A bland cerebrospinal fluid and highly metabolically active brain (18F)-fluoro-D-glucose-positron emission tomography suggested lymphoma. Biopsy of the mass showed sulphur granules with Gram-positive filamentous bacteria with Actinomyces-like colonies. Actinomyces cavernous sinus infections are rare and indolent. They often mimic non-infective causes including other inflammatory and infiltrative conditions, vascular and neoplastic causes, particularly lymphoma. Clinicians should consider infective cavernous sinus syndromes in people with a fluctuating painful ophthalmoplegia that responds poorly to corticosteroids. The term Tolosa-Hunt syndrome is problematic and should be retired or used only with reservation.
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Affiliation(s)
- Michal Lubomski
- Department of Neurology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,School of Medicine, The University of Notre Dame Australia, Sydney, New South Wales, Australia
| | - James Dalgliesh
- Department of Ophthalmology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Kenneth Lee
- Department of Anatomical Pathology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Omprakash Damodaran
- Department of Neurosurgery, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Genevieve McKew
- Department of Infectious Disease, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Concord Clinical School, The University of Sydney, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Stephen Reddel
- Department of Neurology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Concord Clinical School, The University of Sydney, Concord Repatriation General Hospital, Concord, New South Wales, Australia
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Sehnal B, Beneš J, Kolářová Z, Mojhová M, Zikán M. Pelvic actinomycosis and IUD. Ceska Gynekol 2018; 83:386-390. [PMID: 30848144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To summarize knowledge about the mana-gement in women with proven actinomyces in uterine cervix and inserted intrauterine device (IUD). DESIGN An overall review. RESULTS Actinomycosis is an uncommon but important subacute or chronic infection caused by anaerobic or microaerophilic bacteria, mainly within the Actinomyces genus. Actinomycosis can affect various organs and tissues in the human body, often manifesting draining sinuses, abscess formation and fibrosis. The pelvic form in women is the most common in the developed countries. Long-duration treatment with antibiotics can be completely effective even in cases of heavy disease. Although pelvic actinomycosis is predominantly associated with the longstanding use of intrauterine device, the risk of future symptomatic infection is extremly low even in women with a cervical Pap smear positive for actinomyces-like organisms (ALO). Therefore the identification of actinomycetes by cytology after cervical Pap smears is not diagnostic nor predictive of any disease because the actinomycetes normally reside in the female genital tract. In the absence of symptoms, patients with ALO on a Pap test do not need antimicrobial treatment or IUD removal. Nevertheless, women choosing an IUD for contraception should know that there is very low risk of developing the infection in later years after insertion. CONCLUSION The sources of literature conclude that removal of the intrauterine device in a patients with a positive ALO in the uterine cervix is not necessary and antibiotics treatment is not required. However, IUD must be changed at least every five years in order to limit the risk of the development of pelvic actinomycosis.
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Kansu L. Relation of Actinomyces with Tonsillar Hypertrophy and Antibiotic Use. Turk Arch Otorhinolaryngol 2017; 55:17-21. [PMID: 29392046 DOI: 10.5152/tao.2017.2176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 01/19/2016] [Indexed: 11/22/2022] Open
Abstract
Objective This study aimed to investigate the incidence of Actinomyces in tonsillar tissues of patients undergoing tonsillectomy and to determine the association among tonsillar volume, preoperative antibiotic use, and presence of Actinomyces in tonsil tissues. Methods In this study, 142 patients who underwent tonsillectomy in last four years were included. Of the total patients, 97 (66.9%) were children and 47 (33.1%) were adults. The patients' age, sex, preoperative antibiotic use, tonsillar volume, and presence of actinomyces in tonsillar tissues were recorded. Results Actinomyces was identified in tonsillar tissues of 16 (16.4%) pediatric and 21 (44.6%) adult patients. Of all pediatric patients positive for Actinomyces, 13 were males and three were females whereas of all adult patients positive for actinomyces, 14 were males and seven were females. Tonsillar tissue volumes in both pediatric and adult patients positive for Actinomyces were statistically higher than the Actinomyces negative ones. Antibiotic use was higher and the incidence of Actinomyces was lower in pediatric patients than in adult patients positive for Actinomyces. Conclusion Our study results revealed that Actinomyces was prominent in adult patients with tonsillar hypertrophy. In addition, the frequent use of antibiotic decreased the incidence of Actinomyces in tonsillar tissues.
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Affiliation(s)
- Leyla Kansu
- Department of Otorhinolaryngology, Başkent University School of Medicine Alanya Research and Application Hospital, Antalya, Turkey
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Ramanan P, Qureshi AS, Martin SA, Zea D, Patel R, Pritt BS. A 79-Year-Old Man With Chronic Aspiration and an 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computerized Tomography Positive Lung Mass. Open Forum Infect Dis 2017; 4:ofw256. [PMID: 28702466 PMCID: PMC5499773 DOI: 10.1093/ofid/ofw256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 11/21/2016] [Indexed: 11/18/2022] Open
Affiliation(s)
| | | | | | - Diego Zea
- Infectious Diseases, Mayo Clinic Health System, Eau Claire, Wisconsin
| | - Robin Patel
- Divisions of Clinical Microbiology.,Infectious Diseases, Mayo Clinic, Rochester, Minnesota
| | - Bobbi S Pritt
- Divisions of Clinical Microbiology.,Infectious Diseases, Mayo Clinic, Rochester, Minnesota
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Ghanem S, Zaarour M, Ibrahim U, Saouma S, Liu Y, Kong F, Atallah JP. Persistence of a Cervical Neck Mass, Not Just the Lymphoma. Cureus 2016; 8:e746. [PMID: 27699142 PMCID: PMC5039034 DOI: 10.7759/cureus.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Actinomycosis is a rare, chronic granulomatous infection caused by gram-positive, anaerobic to microaerophilic branching filamentous bacteria. In the cervicofacial region, it usually presents as an enlarging neck mass. It remains a diagnostic challenge due to the fact that cultures show no growth in more than 50% of cases. We report a case of a 67-year-old patient known to have a neck mass secondary to lymphoma in which the neck mass persisted despite therapy. Upon evaluation, the diagnosis of culture-negative actinomycosis was based on histopathology findings, and the patient received antibiotic therapy. We will discuss the diagnosis and pathology of actinomycosis, attempting to explore the relationship between actinomycosis and lymphoid malignancy.
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Affiliation(s)
| | | | | | - Samer Saouma
- Internal Medicine, Staten Island University Hospital
| | - Ying Liu
- Pathology and Laboratory Medicine, Staten Island University Hospital
| | - Fanyi Kong
- Pathology and Laboratory Medicine, Staten Island University Hospital
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Affiliation(s)
- Kiyoshi Shikino
- Department of General Medicine, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba-city, Chiba pref., Japan,
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Smid MC, Bhardwaj NR, Di Giovanni LM, Eggener S, Torre MD. Renal hemorrhagic actinomycotic abscess in pregnancy. Infect Dis Rep 2014; 6:5157. [PMID: 24757509 PMCID: PMC3987246 DOI: 10.4081/idr.2014.5157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/29/2014] [Accepted: 02/04/2014] [Indexed: 11/23/2022] Open
Abstract
Actinomyces israelii is a gram-positive, filamentous anaerobic bacteria colonizing the oral and gastrointestinal tracts. Retroperitoneal actinomycotic abscess is uncommon and its rare presentation as a hemorrhagic mass may be confused with malignancy. We present a case of this unusual infection complicating pregnancy. Increased awareness of actinomycotic abscess in the differential diagnosis of renal mass concerning for malignancy is critical to early recognition and treatment of this rare infection and most importantly, avoidance of unnecessary surgical intervention.
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Affiliation(s)
- Marcela C Smid
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of North Carolina at Chapel Hill School of Medicine , NC, USA ; Department of Obstetrics and Gynecology, Chicago Lying in Hospital, University of Chicago Medicine , IL, USA
| | - Neha R Bhardwaj
- Department of Obstetrics and Gynecology, Chicago Lying in Hospital, University of Chicago Medicine , IL, USA
| | - Laura M Di Giovanni
- Department of Obstetrics and Gynecology, Chicago Lying in Hospital, University of Chicago Medicine , IL, USA
| | - Scott Eggener
- Section of Urology, University of Chicago Medicine , IL, USA
| | - Micaela Della Torre
- Department of Obstetrics and Gynecology, Chicago Lying in Hospital, University of Chicago Medicine , IL, USA
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Westermeyer HD, Ward DA, Whittemore JC, Lyons JA. Actinomyces endogenous endophthalmitis in a cat following multiple dental extractions. Vet Ophthalmol 2013; 16:459-63. [PMID: 23281798 DOI: 10.1111/vop.12023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
An 8-year-old, brachycephalic, mixed breed cat underwent full mouth tooth extractions for the treatment of tooth root abscessation. Subsequently, the cat developed anterior uveitis refractory to topical therapy that eventually necessitated enucleation. Actinomyces species were isolated from both the tooth root abscesses and the anterior chamber after enucleation. Histopathology of the enucleated eye revealed panophthalmitis with abundant intralesional bacteria morphologically consistent with Actinomyces. Between the time of tooth root extraction and enucleation (20 weeks), the cat was diagnosed with hyperthyroidism and treated with oral steroids for inflammatory bowel syndrome. We believe this report represents a rare case of endogenous endophthalmitis secondary to dental disease, possibly precipitated by concurrent immunosuppression.
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Affiliation(s)
- Hans D Westermeyer
- Peace Avenue Veterinary Clinic, 7B Liberty Avenue, Mong Kok, Kowloon, Hong Kong
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Abstract
Context: Infection of following total hip arthroplasties can be classified based on the timing of infection. Late infections with Actinomyces israelii are extremely rare with only 3 previously reported cases in literature. We present another case of a late infection with Actinomyces israelii in a total hip arthroplasty 9 years following implantation. Case Report: A 71-year-old male with diabetes mellitus presented with right hip pain 9 years following a total hip arthroplasty. Physical examination revealed localised pain and biochemical investigations showed elevated inflammatory markers. X-rays were suspicious for infection and a collection around the prosthesis was confirmed by MRI scan. The patient underwent debridement and removal of prosthesis. Peri-operative specimen cultures isolated Actinomyces israelii. The patient responded to a combination of vancomycin followed by ciprofloxacin and linezolid therapy before undergoing a successful second-stage reimplantation surgery. Conclusion: This is the first reported case of late haematogenous infection by Actinomyces israelii in a total hip arthroplasty in a patient with diabetes mellitus as the only risk factor. The patient was successfully treated with antibiotic therapy and two-stage reimplantation arthroplasty.
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Affiliation(s)
- Feiran Wu
- University Department of Orthopaedic Surgery, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
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Abstract
OBJECTIVE About 10-15% of US adults are 'refractory' to therapy for chronic periodontitis. Recently, studies suggest that these patients have elevated lysine decarboxylase activity in the sulcular microbiota. The aim of this study was to determine whether an elevated IgG antibody response to lysine decarboxylase, alone or with antibody to other bacterial antigens and baseline clinical measurements, would predict 'refractory' patients with high accuracy. METHODS Chronic periodontitis patients were treated using scaling and root planing (SRP) followed by maintenance SRP and 3-monthly re-examinations. If there was a loss of mean full mouth attachment or more than three sites appeared with > 2.5 mm new loss within a year, the subjects were re-treated (modified Widman flap surgery and systemically administered tetracycline). If attachment loss as above recurred, the subjects were 'refractory'. Baseline clinical measurements and specific antibody responses were used in a logistic regression model to predict 'refractory' subjects. RESULTS Antibody to a peptide portion of lysine decarboxylase (HKL-Ab) and baseline bleeding on probing (BOP) prevalence measurements predicted attachment loss 3 months after initial therapy [pIAL = loss (0) or gain (1)]. IgG antibody contents to a purified antigen from Actinomyces spp. (A-Ab) and streptococcal d-alanyl glycerol lipoteichoic acid (S-Ab) were related in 'refractory' patients (R2 = 0.37, p < 0.01). From the regression equation, the relationship between the antibodies was defined as linear (pLA/S-Ab = 0) or non-linear pLA/S-Ab = 1). Using pLA/S-Ab, pIAL and age, a logistic regression equation was derived from 48 of the patients. Of 59 subjects, 37 had 2-4 mm attachment loss and were assigned as 'refractory' or successfully treated with 86% accuracy. CONCLUSION HKL-Ab facilitated an accurate prediction of therapeutic outcome in subjects with moderate periodontitis.
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Affiliation(s)
- M Levine
- Department. Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
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