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1.
Rev. medica electron ; 43(2): 3212-3221, mar.-abr. 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1251938

ABSTRACT

RESUMEN Se presentó el caso de una actinomicosis ósea, que se manifestó como una lesión de la piel en la zona correspondiente al segundo metatarsiano izquierdo. Por el antecedente de ser la paciente operada de un tumor de células gigantes, se pensó en una recidiva tumoral. Fue intervenida quirúrgicamente y se realizó exéresis del segundo metatarsiano y de la piel afectada. La biopsia informó actinomicosis. Se trató a la paciente con amoxicilina; evolucionando satisfactoriamente, y dando seguimiento en consulta (AU).


ABSTRACT The authors presented the case of a bone actinomycosis expressed as a skin lesion in the area of the second left metatarsals. Due to the antecedent of having undergone a surgery of a giant cell tumor, a tumor recurrence was thought. Surgical intervention was performed and the excision of the second metatarsals and affected skin was performed. The biopsy reported Actinomycosis. The patient was treated with amoxicillin. She had a satisfactory evolution and is still followed up in consultation (AU).


Subject(s)
Humans , Female , Actinomycosis/diagnosis , Forefoot, Human/pathology , Patients , Therapeutics , Biopsy/methods , Bone Diseases, Infectious/diagnosis , Actinomycosis/surgery , Actinomycosis/complications , Case Reports
2.
Arch. argent. pediatr ; 119(2): e153-e157, abril 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1152048

ABSTRACT

La actinomicosis es una infección causada por un bacilo anaerobio Gram-positivo, filamentoso, ramificado, no esporulado. Integra la flora habitual de la orofaringe y coloniza transitoriamente el tracto gastrointestinal, genital femenino y el árbol bronquial. Es poco frecuente en el hueso temporal. Por su semejanza a un hongo, es difícil su reconocimiento, lo que hace necesaria la sospecha clínica para obtener los cultivos apropiados en condiciones anaeróbicas en forma prolongada. Los hallazgos microscópicos típicos incluyen necrosis con gránulos de azufre amarillento y la presencia de filamentos que se asemejan a infecciones fúngicas. El tratamiento requiere de elevadas y prolongadas dosis de antibiótico con penicilina o amoxicilina, entre 6 y 12 meses. La duración de la terapia antimicrobiana podría ser reducida en pacientes que han sido operados quirúrgicamente. Se presenta, a continuación, un caso clínico de actinomicosis en el hueso temporal en un paciente pediátrico que requirió tratamiento quirúrgico para su resolución.


Actinomycosis is an infection caused by a Gram-positive, filamentous anaerobic bacillus. Mainly belonging to the human commensal flora of the oropharynx, it normally colonizes the human digestive and genital tracts and the bronchial tree. It is slightly frequent in the temporal bone. Bacterial cultures and pathology are the cornerstone of diagnosis, but particular conditions are required in order to get the correct diagnosis. Prolonged bacterial cultures in anaerobic conditions are necessary to identify the bacterium and typical microscopic findings include necrosis with yellowish sulfur granules and filamentous Gram-positive fungal-like pathogens. Patients with actinomycosis require prolonged (6- to 12-month) high doses of penicillin G or amoxicillin, but the duration of antimicrobial therapy could probably be shortened in patients in whom optimal surgical resection of infected tissues has been performed. A pediatric patient with actinomycosis in temporal bone who needed surgery resolution is reported.


Subject(s)
Humans , Male , Child , Temporal Bone , Actinomycosis/diagnosis , Actinomycosis/surgery , Actinomycosis/therapy , Mastoiditis
5.
Autops. Case Rep ; 10(1): 2020137, Jan.-Mar. 2020. ilus
Article in English | LILACS | ID: biblio-1087663

ABSTRACT

Actinomycosis is an uncommon, endogenous, and chronic infection with varied and nonspecific clinical features such as abdominal, pelvic or cervical masses, ulcerative lesions, abscesses, draining fistula, fibrosis, and constitutional symptoms. The disease ensues when the bacteria disrupt the mucosal barrier, invade, and spread throughout interfascial planes. Currently, the diagnosis of actinomycosis is challenging because of its very low frequency and depending on the clinical presentation it may masquerade malignancies. Therapy consists initially in intravenous penicillin, followed by an oral regimen that may be extended until a year of treatment. A timely diagnosis is crucial to avoid extensive therapeutic attempt as surgery. However, a biopsy or drainage of abscesses and fistula's tract may be required not only as a diagnostic procedure as part of the therapy. We report the case of a 72-year-old woman with an abdominal mass initially misdiagnosed as a liposarcoma. A second biopsy of a skin lesion of the abdominal wall made the diagnosis of actinomycosis, avoiding a major surgical procedure. The patient was treated with a long-term course of antibiotics with favorable outcome. Liposarcoma was ruled out after the patient's full recovery with antibiotics and the misdiagnosis was credit to the overconfidence on the immunohistochemical positivity to MDM2.


Subject(s)
Humans , Female , Aged , Actinomycosis/diagnosis , Abdomen/abnormalities , Liposarcoma/diagnosis , Diagnosis, Differential
6.
Medwave ; 20(7): e7986, 2020.
Article in English, Spanish | LILACS | ID: biblio-1122534

ABSTRACT

INTRODUCCIÓN: La actinomicosis es una enfermedad infecciosa poco frecuente, ocasionada por una bacteria Gram positiva. La especie más común es Actinomyces israelii. Dentro de sus formas de presentación, la torácica es la menos frecuente. PRESENTACIÓN DE CASOS: Reportamos dos pacientes con actinomicosis torácica de 8 y 13 años de diferentes zonas geográficas de Perú. El primer caso tuvo empiema necessitatis y el segundo, consolidación pulmonar y hemoptisis recurrente. Ambos tuvieron cierto grado de dificultad en su diagnóstico, pero con una buena respuesta al tratamiento antibiótico y quirúrgico. El diagnóstico fue mediante estudio histopatológico. Sin embargo, no se pudo identificar la especie de Actinomyces. CONCLUSIÓN: La actinomicosis torácica es poco frecuente en niños y se presenta como una lesión parenquimal con posible fistulización a la pared torácica. Este es uno de los pocos casos reportados en la literatura peruana, constituyendo una contribución al conocimiento de esta enfermedad y su manejo en pediatría.


INTRODUCTION: Actinomycosis is a rare infectious disease caused by Gram-positive bacteria. The most common species is Actinomyces israelii. Among its forms of presentation, the thoracic is the least frequent. CASE PRESENTATION: We report two patients with thoracic actinomycosis, 8 and 13 years old, from different geographical areas of Peru. The first case had empyema necessitans and the second, lung consolidation and recurrent hemoptysis. Both had a certain degree of difficulty in their diagnosis but responded favorably to antibiotics and surgical treatment. The diagnosis was based on the histopathological study. However, we were not able to ascertain the species of actinomyces. CONCLUSION: Thoracic actinomycosis is rare in children and presents as a parenchymal lesion with possible fistulization to the chest wall. This article is one of the few in the Peruvian literature, constituting a contribution to the knowledge of the disease and its management in pediatrics.


Subject(s)
Humans , Male , Female , Child , Adolescent , Actinomyces/isolation & purification , Actinomycosis/diagnosis , Lung Diseases/diagnosis , Peru , Actinomycosis/microbiology , Actinomycosis/therapy , Lung Diseases/microbiology , Lung Diseases/therapy , Anti-Bacterial Agents/administration & dosage
7.
J. coloproctol. (Rio J., Impr.) ; 39(4): 381-384, Oct.-Dec. 2019. tab, ilus
Article in English | LILACS | ID: biblio-1056646

ABSTRACT

Abstract Introduction: Actinomycosis is a rare infectious disease that affects abdominal organs and simulates oncological disease, hardly ever presents itself as a cause of intestinal obstruction. Symptoms: A 43 years old, male patient with two months of left abdominal pain associated to a growth and an 8 kg weight loss, no fever or bowel habit disruption. Interventions: A colonoscopy and an abdominal scanography. Results: A solid heterogeneous 7 × 3.8 cm mass localized in the splenic flexure of the colon with infiltration of its walls and its surrounding fat. Colon cancer was considered as the first diagnostic possibility. During hospitalization, the patient was taken to an emergency exploratory laparotomy, due to an acute abdominal pain with bowel obstruction symptoms. Histopathological diagnosis: Actinomycetoma. Conjoint continuous monitoring with the infectious disease attending, abdominal US and observation did not show new growths. Weight gain and progressive return to daily life was obtained within 8 weeks. Conclusion: In low income countries, intestinal actinomycosis should be considered in the differential diagnosis of abdominal masses and chronic inflammatory processes, patient prognosis with proper management is excellent.


Resumo Introdução: A actinomicose é uma doença infecciosa rara que acomete órgãos abdominais, simula doença oncológica e dificilmente causa de obstrução intestinal. Sintomas: Paciente do sexo masculino, 43 anos, com quadro de dor abdominal esquerda por dois meses, associado ao surgimento de massa e perda de peso de 8 kg, sem febre ou alterações dos hábitos intestinais. Intervenções: Colonoscopia e uma tomografia computadorizada abdominal. Resultados: Observou-se massa sólida heterogênea de 7 × 3,8 cm localizada na flexão esplênica do cólon, com infiltração de suas paredes e gordura adjacente. Câncer de cólon foi a primeira possibilidade diagnóstica considerada. Durante a internação, o paciente foi submetido a uma laparotomia exploradora de emergência, devido a uma dor abdominal aguda com sintomas de obstrução intestinal. Diagnóstico histopatológico: Actinomicetoma. Monitoramento contínuo em conjunto com o tratamento da infecção, ultrassom abdominal e observação; não foram observados novos crescimentos. Ganho de peso e retorno progressivo à vida diária foram observados por oito semanas. Conclusão: Em países de baixa renda, a actinomicose intestinal deve ser considerada no diagnóstico diferencial de massas abdominais e processos inflamatórios crônicos; com manejo adequado, o prognóstico é excelente.


Subject(s)
Humans , Male , Adult , Actinomycosis/diagnosis , Actinomycosis , Tomography, X-Ray Computed , Colonoscopy
8.
Rev. cir. (Impr.) ; 71(6): 557-561, dic. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1058318

ABSTRACT

Resumen Introducción: La actinomicosis, es una infección crónica rara producida por bacterias del género Actinomyces sp. La afectación pélvica es una de sus formas más infrecuentes y en gran parte de los casos se relaciona al uso de un dispositivo intrauterino de larga data o a una cirugía previa. Como otras enfermedades raras, la infección es conocida como "la gran imitadora" por su variada forma de presentación y particular comportamiento pudiendo simular una neoplasia. El tratamiento es fundamentalmente médico y de buenos resultados. Caso Clínico: Damos a conocer el caso de una paciente que se presentó con un cuadro compatible con un tumor de recto, pero que resultó ser actinomicosis. El diagnóstico se realizó en base a la tinción de Gram, el cuadro clínico y el antecedente de un dispositivo intrauterino abandonado por más de 25 años. Fue corroborado posteriormente mediante anatomía patológica y tratada en forma exitosa con antibióticos por un periodo extendido. Conclusión: Si bien la actinomicosis es una patología infrecuente, debe ser considerada en el diagnóstico diferencial de los pacientes que se presentan con tumores de la pelvis. Un alto índice de sospecha y una actitud diagnóstica activa son fundamentales para un tratamiento oportuno, seguro y eficaz de esta enfermedad.


Introduction: Actinomycosis is a rare chronic infection caused by bacterias of the genus Actinomyces sp. Pelvic involvement is one of its most infrequent forms and in many cases it is related to the use of a longstanding intrauterine device or a previous surgery. Like other rare diseases, the infection is known as "the great imitator" because of its varied form of presentation and its particular behavior, which can simulate a neoplasm. The treatment is fundamentally medical with good results. Case Report: We present the case of a patient who presented with a rectal tumor but that turned out to be Actinomycosis. The diagnosis was made based on the Gram stain, the clinical presentation and the history of an intrauterine device left for more than 25 years. It was subsequently corroborated by pathological anatomy and successfully treated with antibiotics for an extended period. Conclusion: Although actinomycosis is an infrequent pathology, it should be considered in the differential diagnosis of patients who present with tumors of the pelvis. An active diagnostic attitude and a high index of suspicion are fundamental for the timely, safe and effective treatment of this disease.


Subject(s)
Humans , Female , Middle Aged , Actinomyces/isolation & purification , Actinomycosis/etiology , Ovarian Neoplasms/diagnosis , Actinomycosis/diagnostic imaging , Tomography, X-Ray Computed , Colonoscopy , Diagnosis, Differential , Intrauterine Devices/adverse effects , Intrauterine Devices/microbiology
9.
Int. j. morphol ; 37(3): 1033-1037, Sept. 2019. graf
Article in Spanish | LILACS | ID: biblio-1012392

ABSTRACT

La infección por Actinomices (actinomicosis), es una entidad poco frecuente y que puede crear dificultades diagnósticas y terapéuticas; principalmente cuando por su presentación se asemeja a neoplasias malignas. El objetivo de este estudio fue reportar un caso de actinomicosis de pared abdominal con infiltración hepática y revisar la evidencia existente. Se trata de una paciente sexo femenino, de 33 años de edad, sin antecedentes quirúrgicos ni de utilización de dispositivos intra-uterinos. Consultó por dolor abdominal y masa palpable a nivel epigástrico. Se estudió con imágenes, las que permitieron verificar una masa de pared abdominal con trayecto fistuloso al hígado. Se realizó una exéresis amplia de la lesión antes descrita. Una vez extirpado el espécimen, se fue a estudio histopatológico, que reveló gránulos de azufre consistentes con actinomices. La paciente evolució de forma satisfactoria, sin inconvenientes. Presentamos un caso poco común de actinomicosis de pared abdominal con infiltración hepática. Cuando se encuentra una gran masa intraperitoneal, la actinomicosis debe incluirse en el proceso de diagnóstico diferencial.


Actinomyces infection (actinomycosis) may create diagnostic conflicts and be confused with malignant neoplasms, especially in the abdomen. The objective of this study was to report a case of abdominal wall actinomycosis with hepatic infiltration, and review the existing evidence. Female patient, 33 years of age, with no surgical history or use of intra-uterine devices. She consulted for abdominal pain and palpable mass at the epigastrium. It was studied with images, which allowed verifying an abdominal wall mass with hepatic fistulae. A broad extirpation of the lesion was performed. The histological study revealed sulfur granules consistent with actinomyces. The patient has evolved satisfactorily, without problems; and is currently in treatment with amoxicillin. We present an unusual case of abdominal wall actinomycosis with hepatic infiltration that resulted in a difficult diagnosis. When a large intraperitoneal mass is found, actinomycosis needs to be included as a differential diagnoses.


Subject(s)
Humans , Female , Middle Aged , Actinomycosis/diagnosis , Actinomycosis/surgery , Actinomycosis/pathology , Abdominal Wall/microbiology , Diagnosis, Differential , Liver Abscess/etiology , Abdominal Neoplasms/diagnosis
10.
Horiz. méd. (Impresa) ; 19(3): 89-95, Set. 2019. ilus, tab
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1022505

ABSTRACT

Se reporta el caso de un paciente de 58 años, quien acude al hospital con tiempo de enfermedad de 8 meses caracterizado por múltiples abscesos en piel y tejidos blandos, asociado a pérdida de peso de aproximadamente 20 kg, hipoalbuminemia severa, anemia moderada y poliserositis. Se realizaron diversos estudios de imágenes que evidenciaron colecciones en plano muscular de muslo izquierdo. Además, en la ecografía de abdomen, pelvis y tórax se reportó nefropatía intersticial bilateral, ascitis y derrame pleural bilateral. El estudio histopatológico confirmó el diagnóstico de actinomicosis. Por las manifestaciones sistémicas y la distribución difusa de los abscesos, clínicamente correspondía a un caso de actinomicosis diseminada, por lo que recibió tratamiento antibiótico endovenoso con penicilina G sódica por 4 semanas, y luego, amoxicilina por vía oral. El paciente evolucionó favorablemente y los abscesos remitieron.


This case report describes a 58-year-old patient who visited the hospital after an 8-month disease period characterized by multiple skin and soft tissue abscesses associated with an approximately 20-kg weight loss, severe hypoalbuminemia, moderate anemia and polyserositis. Several imaging tests revealed abscesses on the left thigh muscle. Additionally, abdomen, pelvis and thorax ultrasounds showed bilateral interstitial nephropathy, ascites and bilateral pleural effusion. The histopathological examination confirmed the diagnosis of actinomycosis. Given the systemic manifestations and diffuse distribution of the abscesses, the case was clinically consistent with disseminated actinomycosis. Therefore, the patient received IV antibiotic treatment with penicillin G sodium for 4 weeks and then with amoxicillin p.o. The patient evolved favorably and exhibited abscess remission.


Subject(s)
Male , Actinomycosis , Skin , Suppuration
11.
Rev. bras. ginecol. obstet ; 41(7): 463-466, July 2019. graf
Article in English | LILACS | ID: biblio-1020602

ABSTRACT

Abstract Asymptomatic female genital tract colonization with Actinomyces spp is not uncommon, particularly among intrauterine device users. Pelvic actinomycosis is an extremely rare disease. The clinical picture can resemble an advanced ovarian malignancy. We report a case of pelvic actinomycosis mimicking ovarian malignancy diagnosed postoperatively. Preoperative diagnosis is possible if there is a high index of suspicion, obviating extensive surgery and preserving fertility, since long term antibiotic treatment can be completely effective. Pelvic actinomycosis should be included in the differential diagnosis of women presenting a pelvic mass, especially if there is intrauterine device use history.


Resumo A colonização assintomática do aparelho genital feminino por Actinomyces spp não é infrequente, sobretudo em utilizadoras de dispositivo intra-uterino. A actinomicose pélvica é uma doença extremamente rara. O quadro clínico pode assemelhar-se ao de uma neoplasia maligna do ovário avançada. Relatamos um caso de actinomicose pélvica, simulando uma neoplasia maligna do ovário, com diagnóstico pós-operatório. O diagnóstico pré-operatório é possível se houver um elevado grau de suspeição, permitindo evitar cirurgias extensas e preservar a fertilidade, uma vez que o tratamento antibiótico prolongado pode ser totalmente eficaz. A actinomicose pélvica deve ser incluída no diagnóstico diferencial da mulher que apresente uma massa pélvica, sobretudo se houver história de uso de dispositivo intra-uterino.


Subject(s)
Humans , Female , Actinomyces/isolation & purification , Actinomycosis/diagnosis , Pelvic Inflammatory Disease/diagnosis , Ovarian Neoplasms/diagnosis , Actinomycosis/therapy , Actinomycosis/diagnostic imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Pelvic Inflammatory Disease/therapy , Pelvic Inflammatory Disease/diagnostic imaging , Diagnosis, Differential , Middle Aged
12.
Rev. bras. anal. clin ; 50(4): 309-314, 20190410. ilus, tab
Article in Portuguese | LILACS | ID: biblio-995955

ABSTRACT

Micetoma é uma infecção que acomete o tecido subcutâneo após a inoculação de microrganismos na pele em locais de pequenos traumas. Caracteriza-se pela ocorrência de tumoração, associada à formação de fistulas e à drenagem de grãos. Trata-se de um grupo de infecções subcutâneas de difícil tratamento com epidemiologia bem definida, acometendo preferencialmente trabalhadores rurais do gênero masculino. Os agentes causadores podem ser fungos ou bactérias. Este artigo propõe-se à revisão dos dados recentes da epidemiologia e tratamento dessas infecções.


Subject(s)
Therapeutics , Actinomycosis , Diagnosis , Mycetoma , Fistula
14.
Article in English | WPRIM | ID: wpr-787172

ABSTRACT

Actinomycosis can mask malignant diseases. This paper reports a case of colonic diffuse large B-cell lymphoma (DLBCL), which was misdiagnosed as abdominal actinomycosis. A 76-year-old woman presented with right flank pain and weight loss. Abdominal CT and colonoscopy revealed a huge ascending colon mass. Despite the initial impression of a malignancy, a colonoscopic biopsy revealed no malignant cells, but sulfur granules and a filamentous organism suggesting actinomycosis. Intravenous penicillin G was administered under the impression of abdominal actinomycosis but her condition deteriorated rapidly. Follow up CT showed markedly increased colon mass and new multiple nodular lesions around the ascending colon. Sono-guided percutaneous biopsy of the nodular lesion was performed. The pathological result was DLBCL. The patient was scheduled to undergo chemotherapy but the patient expired due to cancer progression. The diagnosis of gastrointestinal infiltrating tumors is often difficult because a superficial biopsy usually does not provide a confirmative diagnosis. This case highlights the difficulty in making a correct diagnosis of lymphoma due to the concomitant actinomycosis. Malignant conditions must be considered in cases of actinomycosis with no response to antimicrobial therapy.


Subject(s)
Actinomycosis , Aged , B-Lymphocytes , Biopsy , Colon , Colon, Ascending , Colonic Neoplasms , Colonoscopy , Diagnosis , Drug Therapy , Female , Flank Pain , Follow-Up Studies , Humans , Lymphoma , Lymphoma, B-Cell , Lymphoma, Large B-Cell, Diffuse , Masks , Penicillin G , Sulfur , Tomography, X-Ray Computed , Weight Loss
15.
Article in English | WPRIM | ID: wpr-764170

ABSTRACT

Pelvic actinomycosis is an uncommon infectious disease. It induces a chronic, suppurative illness characterized by an infiltrative and granulomatous response and, thus, the clinical and radiologic findings may mimic other inflammatory and neoplastic conditions. A 56-year-old female with a long-standing intrauterine device was diagnosed with pelvic actinomycosis manifesting as a large uterine mass with locally infiltrative spread into surrounding tissue that mimicked uterine malignancy. Actinomyces israelii infection was confirmed with a surgical specimen, and the patient was treated with antibiotic medication. Pelvic actinomycosis must be included in the differential diagnoses of patients with an infiltrative pelvic mass extending across tissue planes or in patients with findings of multiple microabscesses, particularly in a patient with an intrauterine device, even the lesion primarily involves the uterus.


Subject(s)
Actinomyces , Actinomycosis , Communicable Diseases , Diagnosis, Differential , Female , Humans , Intrauterine Devices , Middle Aged , Pelvic Inflammatory Disease , Uterus
16.
Article in English | WPRIM | ID: wpr-761524

ABSTRACT

Actinomycosis can mask malignant diseases. This paper reports a case of colonic diffuse large B-cell lymphoma (DLBCL), which was misdiagnosed as abdominal actinomycosis. A 76-year-old woman presented with right flank pain and weight loss. Abdominal CT and colonoscopy revealed a huge ascending colon mass. Despite the initial impression of a malignancy, a colonoscopic biopsy revealed no malignant cells, but sulfur granules and a filamentous organism suggesting actinomycosis. Intravenous penicillin G was administered under the impression of abdominal actinomycosis but her condition deteriorated rapidly. Follow up CT showed markedly increased colon mass and new multiple nodular lesions around the ascending colon. Sono-guided percutaneous biopsy of the nodular lesion was performed. The pathological result was DLBCL. The patient was scheduled to undergo chemotherapy but the patient expired due to cancer progression. The diagnosis of gastrointestinal infiltrating tumors is often difficult because a superficial biopsy usually does not provide a confirmative diagnosis. This case highlights the difficulty in making a correct diagnosis of lymphoma due to the concomitant actinomycosis. Malignant conditions must be considered in cases of actinomycosis with no response to antimicrobial therapy.


Subject(s)
Actinomycosis , Aged , B-Lymphocytes , Biopsy , Colon , Colon, Ascending , Colonic Neoplasms , Colonoscopy , Diagnosis , Drug Therapy , Female , Flank Pain , Follow-Up Studies , Humans , Lymphoma , Lymphoma, B-Cell , Lymphoma, Large B-Cell, Diffuse , Masks , Penicillin G , Sulfur , Tomography, X-Ray Computed , Weight Loss
17.
Acta méd. colomb ; 43(3): 171-174, jul.-set. 2018. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-983701

ABSTRACT

Resumen Paciente masculino de 17 años, con cuadro de PLR desde los 18 meses, al que se le han realizado 85 intervenciones a nivel laringo-traqueal, por lo que requirió traqueostomía permanente desde los cinco años, presentando cuadros de neumonías a repetición con invasión papilomatosa a pulmón de predominio derecho con aislamiento de actinomicetos; desarrolló empiema at neccesitatis del que se aislaron múltiples gérmenes multirresistentes con severo compromiso del parénquima pulmonar por lo que requirió neumonectomía radical derecha en intento de controlar la infección. Fue manejado con anfotericina B deoxicolato, meropenem, tigeciclina y polimixina B a pesar de lo cual presenta empeoramiento del cuadro clínico con posterior choque séptico refractario que lo llevó a la muerte.


Abstract A 17-year-old male patient, with a clinical picture of RRP since18 months of age, who underwent 85 interventions at the laryngo-tracheal level, requiring permanent tracheostomy from the age of 5, presenting recurrent pneumonia with lung papillomatous invasion of right predominance with actinomycete isolation. He developed empyema at neccesitatis from which multiple multiresistant organisms with severe compromise of the pulmonary parenchyma were isolated, which required a right radical pneumonectomy in an attempt to control the infection. He was managed with am-photericin B deoxycholate, meropenem, tigecycline and polymyxin B, despite which he presented worsening of the clinical picture with subsequent refractory septic shock that led to his death.


Subject(s)
Humans , Male , Adolescent , Papilloma , Pneumonia , Actinomycosis , Laryngostenosis , Empyema
18.
Int. j. odontostomatol. (Print) ; 12(1): 15-20, Mar. 2018. graf
Article in English | LILACS | ID: biblio-893298

ABSTRACT

ABSTRACT: Actinomycosis is a bacterial infection caused by Actinomyces species, which usually affect the soft tissues of the cervicofacial region of adult males. Clinically, it's characterized by a slow-growing indurated mass, especially in the submandibular area. However, in a few cases, the jaws bones can be affected developing osteomyelitis characteristics. The aim of this paper is to report a rare clinical case of Actinomycotic Osteomyelitis affecting the maxilla of a child, involving the maxillary sinus, orbital and zygomatic areas that was treated by the association of antibiotic therapy and surgical debridement. The patient's 2 years follow-up was uneventful and no signs of the lesion recurrence.


RESUMEN: La actinomicosis es una infección bacteriana causada por la especie Actinomyces, que generalmente afecta los tejidos blandos de la región cervicofacial de los hombres adultos. Clínicamente, se caracteriza por una masa endurecida de crecimiento lento, especialmente en la zona submandibular. Sin embargo, en algunos casos, los huesos de las mandíbulas pueden ser afectados desarrollando características de osteomielitis. El objetivo de este trabajo es reportar un caso clínico poco frecuente de osteomielitis actinomicótica que afecta el maxilar de un niño, envolviendo el área del seno maxilar, y zonas orbitales y cigomáticas que fueron tratadas con la asociación de terapia con antibióticos y desbridamiento quirúrgico. El seguimiento del paciente por 2 años ocurrió sin incidentes y sin signos de recidiva de las lesiones.


Subject(s)
Humans , Female , Child , Osteomyelitis/diagnosis , Palate/microbiology , Palate/pathology , Periapical Diseases/diagnosis , Actinomycosis/diagnosis , Mouth Diseases/diagnosis , Osteomyelitis/pathology , Actinomycosis/pathology , Radiography, Panoramic , Diagnosis, Differential , Hematoxylin , Maxilla , Mouth Diseases/microbiology , Mouth Diseases/pathology
19.
Rev. Soc. Bras. Med. Trop ; 51(1): 7-13, Jan.-Feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-897043

ABSTRACT

Abstract Actinomycosis remains characteristically uncommon, but is still an important cause of morbidity. Its clinical presentation is usually indolent and chronic as slow growing masses that can evolve into fistulae, and for that reason are frequently underdiagnosed. Actinomyces spp is often disregarded clinically and is classified as a colonizing microorganism. In this review of literature, we concomitantly present 11 cases of actinomycosis with different localizations, diagnosed at a tertiary hospital between 2009 and 2016. We outline the findings of at least one factor of immunosuppression in > 90% of the reported cases.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Penicillins/administration & dosage , Actinomycosis/drug therapy , Immunosuppression , Amoxicillin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Actinomycosis/diagnosis , Actinomycosis/pathology , Treatment Outcome , Middle Aged
20.
Annals of Coloproctology ; : 152-156, 2018.
Article in English | WPRIM | ID: wpr-715239

ABSTRACT

PURPOSE: Primary anal actinomycosis of cryptoglandular origin, a rare cause of anal suppurative disease, requires specific management to be cured. The aims of this retrospective study were to describe clinical, morphological, and microbiological features of this entity and to evaluate management practices for new cases observed since 2001. METHODS: This was a retrospective case series conducted at the Diaconesses-Croix Saint-Simon Hospital in Paris. RESULTS: From January 2001 to July 2016, 7 patients, 6 males and 1 female (median, 49 years), presenting with an actinomycotic abscess with a cryptoglandular anal fistula were included for study. The main symptom was an acute painful ischioanal abscess. One patient exhibited macroscopic small yellow granules (“sulfur granules”), another “watery pus” and a third subcutaneous gluteal septic metastasis. All patients were overweight (body mass index ≥ 25 kg/m2). Histological study of surgically excised tissue established the diagnosis. All the patients were managed with a combination of classical surgical treatment and prolonged antibiotic therapy. No recurrence was observed during follow-up, the median follow-up being 3 years. CONCLUSION: Actinomycosis should be suspected particularly when sulfur granules are present in the pus, patients have undergone multiple surgeries or suppuration has an unusual aspect. Careful histological examination and appropriate cultures of pus are needed to achieve complete eradication of this rare, but easily curable, disease.


Subject(s)
Abscess , Actinomycosis , Acute Pain , Diagnosis , Female , Follow-Up Studies , Humans , Male , Neoplasm Metastasis , Overweight , Rectal Fistula , Recurrence , Retrospective Studies , Sulfur , Suppuration
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