Actinomycosis is an uncommon chronic infectious disease. Common sites of involvement include the cervicofacial, thoracic and abdominopelvic regions. In abdominopelvic actinomycosis, the ileocecal region, including the...Actinomycosis is an uncommon chronic infectious disease. Common sites of involvement include the cervicofacial, thoracic and abdominopelvic regions. In abdominopelvic actinomycosis, the ileocecal region, including the appendix, is the most commonly involved site. In some reports, limited appendiceal actinomycosis has revealed a thickened appendiceal wall with peri-appendiceal inflammation as acute appendicitis or perforated appendicitis. We experienced pathologically confirmed intraluminal limited appendiceal actinomycosis without peri-appendiceal infiltration. Here, we report the computed tomography and ultrasound findings.展开更多
Abdominal actinomycosis is a chronic suppurative infection caused by Actinomyces species.The ileo-cecal region is most commonly affected,while the left side of the colon is more rarely involved.The infection has a ten...Abdominal actinomycosis is a chronic suppurative infection caused by Actinomyces species.The ileo-cecal region is most commonly affected,while the left side of the colon is more rarely involved.The infection has a tendency to inf iltrate adjacent tissues and is therefore rarely confined to a single organ.Presentation may vary from non specif ic symptoms and signs to an acute abdomen.A computed tomography scan is helpful in identifying the inflammatory process and the organs involved.It also allows visual guidance for percutaneous drainage of abscesses,thus aiding diagnosis.Culture is difficult because of the anaerobic character and slow growth of actinomycetes.Colonoscopy is usually normal,but may shows signs of external compression.Preoperative diagnosis is rare and is established only in less than 10% of cases.In uncomplicated disease,high dose antibiotic therapy is the mainstay of treatment.Surgery is often performed because of a difficulty in diagnosis.Surgery and antibiotics are required in the case of complicated disease.Combined medical and surgical treatment achieves a cure in about 90% of cases.The authors report a case of sigmoid actinomycosis where diagnosis was made from the histology,and a review of the literature is presented.展开更多
Hepatic actinomycosis is rare,with few published cases.There are no characteristic clinical manifestations,and computed tomography(CT)shows mainly low-density images,making clinical diagnosis difficult,and leading to ...Hepatic actinomycosis is rare,with few published cases.There are no characteristic clinical manifestations,and computed tomography(CT)shows mainly low-density images,making clinical diagnosis difficult,and leading to frequent misdiagnosis as primary liver cancer,metastatic liver cancer or liver abscess.Diagnosis normally requires examination of both the aetiology and pathology.This article reports one male patient aged 55 who was hospitalized because of repeated upper abdominal pain for more than 2 mo.He exhibited no chills,fever or yellow staining of the skin and sclera,and examination revealed no positive signs.The routine blood results were:haemoglobin 110 g/L,normal numbers of leukocytes and neutral leukocytes,serum albumin 32g/L,negative serum hepatitis B markers and hepatitis C antibodies,normal tumour markers(alpha-fetoproteinand carcinoembryonic antigen).An abdominal CT scan revealed an 11.2 cm×5.8 cm×7.4 cm mass with an unclear edge in the left liver lobe.The patient was diagnosed as having primary liver cancer,and left lobe resection was performed.The postoperative pathological examination found multifocal actinomycetes in the hepatic parenchyma,which was accompanied by chronic suppurative inflammation.A focal abscess had formed,and large doses of sodium penicillin were administered postoperatively as anti-infective therapy.This article also reviews 32 cases reported in the English literature,with the aim of determining the clinical features and treatment characteristics of this disease,and providing a reference for its diagnosis and treatment.展开更多
Abdominal wall actinomycosis is a rare disease frequently associated with the presence of an intra uterine device.We report on a case of a 47-year-old woman who had used an intrauterine device for many years and had r...Abdominal wall actinomycosis is a rare disease frequently associated with the presence of an intra uterine device.We report on a case of a 47-year-old woman who had used an intrauterine device for many years and had removed it about a month prior to the identif ication of an abdominal wall abscess caused by Actinomyces israelii.The abscess mimicked a malignancy and the patient underwent a demolitive surgical treatment.The diagnosis was obtained only after histopathological examination.Postoperatively,the patient developed an infection of the wound which was treated with daily medication.The combination of long-term high dose antibiotic therapy with surgery led to successful treatment.展开更多
Actinomycosis is an uncommon disease, which is usually manifested as cervicofacial infection; related to poor oral hygiene or compromised immune function. Pulmonary actinomycosis is rare, but its diagnosis is changing...Actinomycosis is an uncommon disease, which is usually manifested as cervicofacial infection; related to poor oral hygiene or compromised immune function. Pulmonary actinomycosis is rare, but its diagnosis is changing due to its variable presentation; the similarity in appearance to other intrapulmonary diseases. Here we report an 80-year-old man with a solitary pulmonary nodule over the left upper lobe. Pulmonary neoplasm was highly suspected in this patient; thus resection of the mass was undertaken through video-assisted thoracic surgery (VATS). Histopathological examination demonstrated this patient had an Actinomyeces infection. While the application of VATS in patients with pulmonary actinomycosis has rarely been reported in literature, we conclude that VATS is valuable for the diagnosis; treatment of patients with undetermined pulmonary nodule(s).展开更多
Actinomycosis is a rare chronic granulomatous disease.Here we reported a 23-year-old male presented with a neck mass in the antero-inferior part for 35 days,with increasing in size and appearing some new masses in var...Actinomycosis is a rare chronic granulomatous disease.Here we reported a 23-year-old male presented with a neck mass in the antero-inferior part for 35 days,with increasing in size and appearing some new masses in various sizes on left side of neck.The masses improved to some extent,with an empirical therapy but relapsed after discontinuation of treatment.After further investigations in second admission,long-term treatment with penicillin was started with a diagnosis of cervicofacial actinomycosis.Bronchial cleft actinomycosis was proved in this patient, which is one of rare cases of actinomyces involvement.展开更多
Actinomycosis is a rare, chronic, spreading, suppurative,granulomatous and fibrosing infection. Actinomyces are normal inhabitants of the oral cavity and gastrointestinal tract. They rarely cause disease and are seldo...Actinomycosis is a rare, chronic, spreading, suppurative,granulomatous and fibrosing infection. Actinomyces are normal inhabitants of the oral cavity and gastrointestinal tract. They rarely cause disease and are seldom reported as pathogens. Herein, we reported on a 69-year-old male patient who had undergone Whipple's operation due to ampulla Vater carcinoma, and became infected with actinomycosis at the pancreaticojejunostomy, which mimicked a recurrent malignancy. He was treated with radical resection of the mass at the pancreaticojejunostomy and had an uneventful postoperative course.展开更多
Since actinomycosis sometimes causes an abdominal tumor which mimics malignancy, treatment strategy varies from case to case. We herein report two cases which were treated with a combination of antibiotics and surgica...Since actinomycosis sometimes causes an abdominal tumor which mimics malignancy, treatment strategy varies from case to case. We herein report two cases which were treated with a combination of antibiotics and surgical intervention. Both patients presented with an intra-abdominal tumor lesion mimicking malignant disease after an appendectomy for acute appendicitis. Case 1 received surgical extirpation of the abdominal tumor in the liver and kidney twice since the clinical diagnosis of actinomycosis was not made. In contrast, case 2 was successfully treated by a combination of antibiotics and laparoscopic surgery following the experience of case 1. When a high probability diagnosis can be made, a laparoscopic approach is a useful and effective option to treat this condition.展开更多
BACKGROUND Primary hepatic actinomycosis is a rare infection that can be clinically confused with hepatic pyogenic abscesses or neoproliferative processes.Only a few cases of primary hepatic actinomycosis in children ...BACKGROUND Primary hepatic actinomycosis is a rare infection that can be clinically confused with hepatic pyogenic abscesses or neoproliferative processes.Only a few cases of primary hepatic actinomycosis in children have been reported in the English literature.CASE SUMMARY We describe a pediatric patient with primary hepatic actinomycosis that involved the base of the right lung and anterior abdominal wall and skin.The patient was diagnosed via histological examination of spontaneously drained material.The patient was successfully treated with an exploratory laparotomy and right posterior segmentectomy of the liver,combined with antibiotic treatment.Following surgery,the patient remains in excellent condition,without evidence of recurrence at the time of drafting this report.To summarize the clinical manifestations,diagnosis,treatment,and outcomes of primary hepatic actinomycosis,18 case reports in English were reviewed.CONCLUSION We conclude that actinomycosis clinically features a chronic onset,nonspecific symptoms,and a primarily histologic diagnosis.Prolonged antibiotic treatment combined with invasive intervention provides a good prognosis.展开更多
Thoracic actinomycosis is a rare disease in the era of antibiotics. Infection involving the mediastinum is extremely infrequent and the symptoms are nonspecific. It’s very important to include actinomycosis in the di...Thoracic actinomycosis is a rare disease in the era of antibiotics. Infection involving the mediastinum is extremely infrequent and the symptoms are nonspecific. It’s very important to include actinomycosis in the differential diagnosis of pulmonary affections and mediastinal masses. We present a case of posterior mediastinal mass found on chest computed tomography and the patient was treated with penicillin and fully recovered.展开更多
Purpose: Actinomyces israelii is known as the key species to cause classical actinomycosis. Although A. israelii is frequently isolated from human oral cavities, the distribution of this microorganism has been little ...Purpose: Actinomyces israelii is known as the key species to cause classical actinomycosis. Although A. israelii is frequently isolated from human oral cavities, the distribution of this microorganism has been little reported. The purpose of the present study was to develop selective media (AISM) for the isolation of A. israelii and to assess the prevalence of this organism in the oral cavity. Methods: To examine the bacterial population in the oral cavity, a novel selective medium (AISM) was developed for isolating A. israelii. AISM consists of BHI, yeast extract, agar, ofloxacin, fosfomycin, colistin, and sodium fluoride. Results: A. israelii strains grew well on AISM. A. israelii was detected in all dental plaque samples collected from 20 subjects and the mean number of this organism in the samples was 7.9 × 104 CFU/ml. Conclusion: These results indicated that the selective medium was useful for the isolation of A. israelii and this organism was a part of the normal flora in the human oral cavity.展开更多
We present an unusual case of esophageal actinomycosis that developed in a patient with normal immunity and a history of acute SARS-CoV-2 infection. We report a case of a 56-year-old female patient without chronic deg...We present an unusual case of esophageal actinomycosis that developed in a patient with normal immunity and a history of acute SARS-CoV-2 infection. We report a case of a 56-year-old female patient without chronic degenerative pathologies with a history of non-severe acute SARS-CoV-2 infection that occurred two months prior to her presentation, treated with prednisone and betamethasone orally and inhaled, respectively for 21 days. The pivotal symptom is dysphagia and definitive diagnosis requires a tissue culture of the affected organ or a biopsy that shows the classic sulfur granules. Currently, antibiotic treatment with beta-lactams, such as amoxicillin/clavulanic acid, is still effective, as it was in our patient.展开更多
<strong>Background:</strong> Actinomycosis is a bacterial infection characterized by a chronic, suppurative and granulomatous process. The causative organism was identified in 1891 as <em>Actinomycos...<strong>Background:</strong> Actinomycosis is a bacterial infection characterized by a chronic, suppurative and granulomatous process. The causative organism was identified in 1891 as <em>Actinomycosis israelii</em>. The disease is usually caused by the introduction of the bacteria through minor wound. Actinomycosis was classified by Cope into 3 different forms: cervicofacial (50%), pulmonothoracic (30%) and abdominopelvic (20%). Actinomycosis is an insidious disease but occasionally the clinical course can be more aggressive, involving underline tissue and organs. Involvement of scalp by actinomycosis is rare causing diagnostic dilemma and could be mistaken for different pathologies, such as tuberculosis or carcinoma. The most common clinical findings are local tumefaction with abscesses and sinuses draining pus that contains the granule of the causative organism. CT scan and MRI are aspecific for diagnosis, but they can help in defining the localization and the extension of the lesion. The certain diagnostic is based on cytology and/or biopsy. <strong>Case: </strong>A 24 year-old-man was admitted to our neurosurgical department with a 16-month history of multiple scalp ulcerated lesions and swelling of the head. He was complaining of headache. Physical examination revealed multiple scalp subcutaneous nodules and ulcerated lesions with swelling of the head. Our examination of the oral cavity revealed a poor oral hygiene condition with multiple caries. The CT scan revealed multiple scalp subcutaneous masses with chronic inflammatory changes of the skull. Routine laboratory test was normal. Surgical biopsy was performed and the histological result was compatible with actinomycosis. After histological confirmation, parenteral Penicillin 20 million units daily were given for 4 weeks. Clinical improvement was observed after completing a 4-week regimen of intravenous antibiotics. <strong>Conclusion:</strong> Involvement of scalp by actinomycosis could be mistaken for different pathologies, such as tuberculosis or carcinoma. This emphasizes the importance of biopsy for histological confirmation of the disease.展开更多
Among chronic pulmonary infections, pulmonary actinomycosis is a rare one, caused by a gram-positive microaerophilic bacterium called Actinomyces. Aside from cervicofacial or abdominopelvic actinomycosis, pulmonary in...Among chronic pulmonary infections, pulmonary actinomycosis is a rare one, caused by a gram-positive microaerophilic bacterium called Actinomyces. Aside from cervicofacial or abdominopelvic actinomycosis, pulmonary involvement is rare, and sometimes this type of infection results in a misdiagnosis of pulmonary tuberculosis or carcinoma. Clinical presentation of pulmonary actinomycosis could be acute or subacute, with lobar involvement. However, the disease is most commonly diagnosed at the chronic phase, with patients presenting mild fever, weight loss, and occasional hemoptysis. Here, we described the case of a 30-year-old male patient, presented with a history of respiratory complaints for more than three years and was diagnosed clinically and radiologically as a case of a destroyed left lung. Later on, post-operative tissue diagnosis was confirmed—pulmonary actinomycosis.展开更多
Background：Actinomycosis is a rare indolent infectious disease caused by Actinomyces.Although pulmonary actinomycosis is thought to be more prevalent in developing countries,data from developing countries are scanty....Background：Actinomycosis is a rare indolent infectious disease caused by Actinomyces.Although pulmonary actinomycosis is thought to be more prevalent in developing countries,data from developing countries are scanty.This study was to reveal the current situation of pulmonary actinomycosis in developing countries and the difference from that in developed countries.Methods：Patients fulfilling the inclusion criteria for pulmonary actinomycosis from Peking Union Medical College Hospital in China between January 2003 and December 2014 were retrospectively analyzed.Baseline characteristics,clinical symptoms,underlying diseases,diagnostic methods,pulmonary function test results,chest computed tomography （CT） tests,fluoro-2-deoxy-D-glucose positron emission tomography （FDG-PET） tests,initial diagnosis,treatment and prognosis were retrieved from medical records and analyzed.Results：Twenty-six patients were included in this study （mean age 52.0 ＋ 13.1 years）.The ratio of male to female was 1.17：1.Most common clinical symptoms were cough （15/26）,sputum （12/26） and hemoptysis （12/26）.Chest CT findings presented as masses （13/26）,nodules （10/26） and infiltrates （3/26）.FDG-PET had an increased standardized uptake value and 4/6 patients were misdiagnosed as malignancy.Many kinds of antibiotics were used in the treatment of pulmonary actonomycosis and all got favorable results.Five patients receiving complete resection of the lesion were cured without postoperative use of antibiotic.Conclusions：Pulmonary actinomycosis is a rare disease even in developing countries,and both misdiagnosis and missed diagnosis are common.FDG-PET seems useless in the differential diagnosis,and complete resection of the pulmonary lesion without postoperative antibiotic therapy might be enough to achieve cure.展开更多
The clinical picture of actinomycosis was first described in 1878.Actinomycosis agents are found in the natural flora of the oral cavity, upper gastrointestinal system and female genital systems. Actinomyces israelii ...The clinical picture of actinomycosis was first described in 1878.Actinomycosis agents are found in the natural flora of the oral cavity, upper gastrointestinal system and female genital systems. Actinomyces israelii is usually responsible for the infections and causes chronic suppurative and granulomatous infections. The most common disease form is cervicofascial infection. Liver is involved in 5% of all actinomycosis infections. Liver involvement secondary to any primary infection site in the abdomen frequently occurs. In 15% of abdominal infections the liver is also involved. However, in very rare cases, a primary focus cannot be found, and these cases are called primary or isolated hepatic actinomycosis （IHA）. IHA which is frequently seen as a solitary abscess can be confused with a malignancy both clinically and radiologically.展开更多
文摘Actinomycosis is an uncommon chronic infectious disease. Common sites of involvement include the cervicofacial, thoracic and abdominopelvic regions. In abdominopelvic actinomycosis, the ileocecal region, including the appendix, is the most commonly involved site. In some reports, limited appendiceal actinomycosis has revealed a thickened appendiceal wall with peri-appendiceal inflammation as acute appendicitis or perforated appendicitis. We experienced pathologically confirmed intraluminal limited appendiceal actinomycosis without peri-appendiceal infiltration. Here, we report the computed tomography and ultrasound findings.
文摘Abdominal actinomycosis is a chronic suppurative infection caused by Actinomyces species.The ileo-cecal region is most commonly affected,while the left side of the colon is more rarely involved.The infection has a tendency to inf iltrate adjacent tissues and is therefore rarely confined to a single organ.Presentation may vary from non specif ic symptoms and signs to an acute abdomen.A computed tomography scan is helpful in identifying the inflammatory process and the organs involved.It also allows visual guidance for percutaneous drainage of abscesses,thus aiding diagnosis.Culture is difficult because of the anaerobic character and slow growth of actinomycetes.Colonoscopy is usually normal,but may shows signs of external compression.Preoperative diagnosis is rare and is established only in less than 10% of cases.In uncomplicated disease,high dose antibiotic therapy is the mainstay of treatment.Surgery is often performed because of a difficulty in diagnosis.Surgery and antibiotics are required in the case of complicated disease.Combined medical and surgical treatment achieves a cure in about 90% of cases.The authors report a case of sigmoid actinomycosis where diagnosis was made from the histology,and a review of the literature is presented.
文摘Hepatic actinomycosis is rare,with few published cases.There are no characteristic clinical manifestations,and computed tomography(CT)shows mainly low-density images,making clinical diagnosis difficult,and leading to frequent misdiagnosis as primary liver cancer,metastatic liver cancer or liver abscess.Diagnosis normally requires examination of both the aetiology and pathology.This article reports one male patient aged 55 who was hospitalized because of repeated upper abdominal pain for more than 2 mo.He exhibited no chills,fever or yellow staining of the skin and sclera,and examination revealed no positive signs.The routine blood results were:haemoglobin 110 g/L,normal numbers of leukocytes and neutral leukocytes,serum albumin 32g/L,negative serum hepatitis B markers and hepatitis C antibodies,normal tumour markers(alpha-fetoproteinand carcinoembryonic antigen).An abdominal CT scan revealed an 11.2 cm×5.8 cm×7.4 cm mass with an unclear edge in the left liver lobe.The patient was diagnosed as having primary liver cancer,and left lobe resection was performed.The postoperative pathological examination found multifocal actinomycetes in the hepatic parenchyma,which was accompanied by chronic suppurative inflammation.A focal abscess had formed,and large doses of sodium penicillin were administered postoperatively as anti-infective therapy.This article also reviews 32 cases reported in the English literature,with the aim of determining the clinical features and treatment characteristics of this disease,and providing a reference for its diagnosis and treatment.
文摘Abdominal wall actinomycosis is a rare disease frequently associated with the presence of an intra uterine device.We report on a case of a 47-year-old woman who had used an intrauterine device for many years and had removed it about a month prior to the identif ication of an abdominal wall abscess caused by Actinomyces israelii.The abscess mimicked a malignancy and the patient underwent a demolitive surgical treatment.The diagnosis was obtained only after histopathological examination.Postoperatively,the patient developed an infection of the wound which was treated with daily medication.The combination of long-term high dose antibiotic therapy with surgery led to successful treatment.
文摘Actinomycosis is an uncommon disease, which is usually manifested as cervicofacial infection; related to poor oral hygiene or compromised immune function. Pulmonary actinomycosis is rare, but its diagnosis is changing due to its variable presentation; the similarity in appearance to other intrapulmonary diseases. Here we report an 80-year-old man with a solitary pulmonary nodule over the left upper lobe. Pulmonary neoplasm was highly suspected in this patient; thus resection of the mass was undertaken through video-assisted thoracic surgery (VATS). Histopathological examination demonstrated this patient had an Actinomyeces infection. While the application of VATS in patients with pulmonary actinomycosis has rarely been reported in literature, we conclude that VATS is valuable for the diagnosis; treatment of patients with undetermined pulmonary nodule(s).
文摘Actinomycosis is a rare chronic granulomatous disease.Here we reported a 23-year-old male presented with a neck mass in the antero-inferior part for 35 days,with increasing in size and appearing some new masses in various sizes on left side of neck.The masses improved to some extent,with an empirical therapy but relapsed after discontinuation of treatment.After further investigations in second admission,long-term treatment with penicillin was started with a diagnosis of cervicofacial actinomycosis.Bronchial cleft actinomycosis was proved in this patient, which is one of rare cases of actinomyces involvement.
文摘Actinomycosis is a rare, chronic, spreading, suppurative,granulomatous and fibrosing infection. Actinomyces are normal inhabitants of the oral cavity and gastrointestinal tract. They rarely cause disease and are seldom reported as pathogens. Herein, we reported on a 69-year-old male patient who had undergone Whipple's operation due to ampulla Vater carcinoma, and became infected with actinomycosis at the pancreaticojejunostomy, which mimicked a recurrent malignancy. He was treated with radical resection of the mass at the pancreaticojejunostomy and had an uneventful postoperative course.
文摘Since actinomycosis sometimes causes an abdominal tumor which mimics malignancy, treatment strategy varies from case to case. We herein report two cases which were treated with a combination of antibiotics and surgical intervention. Both patients presented with an intra-abdominal tumor lesion mimicking malignant disease after an appendectomy for acute appendicitis. Case 1 received surgical extirpation of the abdominal tumor in the liver and kidney twice since the clinical diagnosis of actinomycosis was not made. In contrast, case 2 was successfully treated by a combination of antibiotics and laparoscopic surgery following the experience of case 1. When a high probability diagnosis can be made, a laparoscopic approach is a useful and effective option to treat this condition.
基金Supported by National Natural Science Foundation of China,No.81800448.
文摘BACKGROUND Primary hepatic actinomycosis is a rare infection that can be clinically confused with hepatic pyogenic abscesses or neoproliferative processes.Only a few cases of primary hepatic actinomycosis in children have been reported in the English literature.CASE SUMMARY We describe a pediatric patient with primary hepatic actinomycosis that involved the base of the right lung and anterior abdominal wall and skin.The patient was diagnosed via histological examination of spontaneously drained material.The patient was successfully treated with an exploratory laparotomy and right posterior segmentectomy of the liver,combined with antibiotic treatment.Following surgery,the patient remains in excellent condition,without evidence of recurrence at the time of drafting this report.To summarize the clinical manifestations,diagnosis,treatment,and outcomes of primary hepatic actinomycosis,18 case reports in English were reviewed.CONCLUSION We conclude that actinomycosis clinically features a chronic onset,nonspecific symptoms,and a primarily histologic diagnosis.Prolonged antibiotic treatment combined with invasive intervention provides a good prognosis.
文摘Thoracic actinomycosis is a rare disease in the era of antibiotics. Infection involving the mediastinum is extremely infrequent and the symptoms are nonspecific. It’s very important to include actinomycosis in the differential diagnosis of pulmonary affections and mediastinal masses. We present a case of posterior mediastinal mass found on chest computed tomography and the patient was treated with penicillin and fully recovered.
文摘Purpose: Actinomyces israelii is known as the key species to cause classical actinomycosis. Although A. israelii is frequently isolated from human oral cavities, the distribution of this microorganism has been little reported. The purpose of the present study was to develop selective media (AISM) for the isolation of A. israelii and to assess the prevalence of this organism in the oral cavity. Methods: To examine the bacterial population in the oral cavity, a novel selective medium (AISM) was developed for isolating A. israelii. AISM consists of BHI, yeast extract, agar, ofloxacin, fosfomycin, colistin, and sodium fluoride. Results: A. israelii strains grew well on AISM. A. israelii was detected in all dental plaque samples collected from 20 subjects and the mean number of this organism in the samples was 7.9 × 104 CFU/ml. Conclusion: These results indicated that the selective medium was useful for the isolation of A. israelii and this organism was a part of the normal flora in the human oral cavity.
文摘We present an unusual case of esophageal actinomycosis that developed in a patient with normal immunity and a history of acute SARS-CoV-2 infection. We report a case of a 56-year-old female patient without chronic degenerative pathologies with a history of non-severe acute SARS-CoV-2 infection that occurred two months prior to her presentation, treated with prednisone and betamethasone orally and inhaled, respectively for 21 days. The pivotal symptom is dysphagia and definitive diagnosis requires a tissue culture of the affected organ or a biopsy that shows the classic sulfur granules. Currently, antibiotic treatment with beta-lactams, such as amoxicillin/clavulanic acid, is still effective, as it was in our patient.
文摘<strong>Background:</strong> Actinomycosis is a bacterial infection characterized by a chronic, suppurative and granulomatous process. The causative organism was identified in 1891 as <em>Actinomycosis israelii</em>. The disease is usually caused by the introduction of the bacteria through minor wound. Actinomycosis was classified by Cope into 3 different forms: cervicofacial (50%), pulmonothoracic (30%) and abdominopelvic (20%). Actinomycosis is an insidious disease but occasionally the clinical course can be more aggressive, involving underline tissue and organs. Involvement of scalp by actinomycosis is rare causing diagnostic dilemma and could be mistaken for different pathologies, such as tuberculosis or carcinoma. The most common clinical findings are local tumefaction with abscesses and sinuses draining pus that contains the granule of the causative organism. CT scan and MRI are aspecific for diagnosis, but they can help in defining the localization and the extension of the lesion. The certain diagnostic is based on cytology and/or biopsy. <strong>Case: </strong>A 24 year-old-man was admitted to our neurosurgical department with a 16-month history of multiple scalp ulcerated lesions and swelling of the head. He was complaining of headache. Physical examination revealed multiple scalp subcutaneous nodules and ulcerated lesions with swelling of the head. Our examination of the oral cavity revealed a poor oral hygiene condition with multiple caries. The CT scan revealed multiple scalp subcutaneous masses with chronic inflammatory changes of the skull. Routine laboratory test was normal. Surgical biopsy was performed and the histological result was compatible with actinomycosis. After histological confirmation, parenteral Penicillin 20 million units daily were given for 4 weeks. Clinical improvement was observed after completing a 4-week regimen of intravenous antibiotics. <strong>Conclusion:</strong> Involvement of scalp by actinomycosis could be mistaken for different pathologies, such as tuberculosis or carcinoma. This emphasizes the importance of biopsy for histological confirmation of the disease.
文摘Among chronic pulmonary infections, pulmonary actinomycosis is a rare one, caused by a gram-positive microaerophilic bacterium called Actinomyces. Aside from cervicofacial or abdominopelvic actinomycosis, pulmonary involvement is rare, and sometimes this type of infection results in a misdiagnosis of pulmonary tuberculosis or carcinoma. Clinical presentation of pulmonary actinomycosis could be acute or subacute, with lobar involvement. However, the disease is most commonly diagnosed at the chronic phase, with patients presenting mild fever, weight loss, and occasional hemoptysis. Here, we described the case of a 30-year-old male patient, presented with a history of respiratory complaints for more than three years and was diagnosed clinically and radiologically as a case of a destroyed left lung. Later on, post-operative tissue diagnosis was confirmed—pulmonary actinomycosis.
文摘Background：Actinomycosis is a rare indolent infectious disease caused by Actinomyces.Although pulmonary actinomycosis is thought to be more prevalent in developing countries,data from developing countries are scanty.This study was to reveal the current situation of pulmonary actinomycosis in developing countries and the difference from that in developed countries.Methods：Patients fulfilling the inclusion criteria for pulmonary actinomycosis from Peking Union Medical College Hospital in China between January 2003 and December 2014 were retrospectively analyzed.Baseline characteristics,clinical symptoms,underlying diseases,diagnostic methods,pulmonary function test results,chest computed tomography （CT） tests,fluoro-2-deoxy-D-glucose positron emission tomography （FDG-PET） tests,initial diagnosis,treatment and prognosis were retrieved from medical records and analyzed.Results：Twenty-six patients were included in this study （mean age 52.0 ＋ 13.1 years）.The ratio of male to female was 1.17：1.Most common clinical symptoms were cough （15/26）,sputum （12/26） and hemoptysis （12/26）.Chest CT findings presented as masses （13/26）,nodules （10/26） and infiltrates （3/26）.FDG-PET had an increased standardized uptake value and 4/6 patients were misdiagnosed as malignancy.Many kinds of antibiotics were used in the treatment of pulmonary actonomycosis and all got favorable results.Five patients receiving complete resection of the lesion were cured without postoperative use of antibiotic.Conclusions：Pulmonary actinomycosis is a rare disease even in developing countries,and both misdiagnosis and missed diagnosis are common.FDG-PET seems useless in the differential diagnosis,and complete resection of the pulmonary lesion without postoperative antibiotic therapy might be enough to achieve cure.
文摘The clinical picture of actinomycosis was first described in 1878.Actinomycosis agents are found in the natural flora of the oral cavity, upper gastrointestinal system and female genital systems. Actinomyces israelii is usually responsible for the infections and causes chronic suppurative and granulomatous infections. The most common disease form is cervicofascial infection. Liver is involved in 5% of all actinomycosis infections. Liver involvement secondary to any primary infection site in the abdomen frequently occurs. In 15% of abdominal infections the liver is also involved. However, in very rare cases, a primary focus cannot be found, and these cases are called primary or isolated hepatic actinomycosis （IHA）. IHA which is frequently seen as a solitary abscess can be confused with a malignancy both clinically and radiologically.
