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1.
BMJ Case Rep ; 14(11)2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34753731

RESUMO

Actinomycosis is a rare invasive bacterial disease that is characterised by granulomatous inflammation often mistaken as malignancy. Traditionally, this has been managed with prolonged courses of antibiotics with durations up to 6-12 months. Surgical intervention as an adjuvant treatment has been shown to reduce the length of antibiotic treatment significantly to 4 weeks. We report a case of cervicofacial actinomycosis in a 12-year-old girl who was adequately treated with an 11-day course of antibiotics without surgical intervention and shows no signs of recurrence at 6 months post-treatment.


Assuntos
Actinomicose Cervicofacial , Actinomicose , Actinomicose/tratamento farmacológico , Actinomicose Cervicofacial/diagnóstico , Actinomicose Cervicofacial/tratamento farmacológico , Actinomicose Cervicofacial/cirurgia , Antibacterianos/uso terapêutico , Criança , Feminino , Humanos , Recidiva
2.
Laryngorhinootologie ; 100(12): 966-972, 2021 12.
Artigo em Alemão | MEDLINE | ID: mdl-33618377

RESUMO

Actinomycosis is an infectious disease caused by gram-positive, facultative anaerobic bacteria, which in most cases manifests itself in the cervicofacial area and often has a dentogenic focus. The clinical presentation ranges from acute abscess to chronically fistulating soft tissue processes. Early diagnosis and an appropriate therapeutic approach including a combination of extensive antibiotic treatment and, if necessary, surgical intervention are critical. This article presents five cases of actinomycete infections, which are intended to illustrate the variety of clinical presentations, the problems on the way to the correct diagnosis and possible therapeutic courses.


Assuntos
Actinomicose Cervicofacial , Actinomicose , Actinomicose/diagnóstico , Actinomicose/tratamento farmacológico , Actinomicose/cirurgia , Actinomicose Cervicofacial/diagnóstico , Actinomicose Cervicofacial/tratamento farmacológico , Actinomicose Cervicofacial/cirurgia , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Humanos
3.
BMJ Case Rep ; 13(5)2020 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-32467116

RESUMO

Cervicofacial actinomycosis remains a rare pathogenic finding in the paediatric population. Diagnosis is challenging, as findings are often non-specific and Actinomyces species are generally difficult to culture. Treatment is a prolonged course of antibiotics, either intravenous and oral, often combined with a surgical procedure to remove the lesion. This patient had non-specific intermittent left mandibular pain for 8 months that was eventually attributed to an Actinomyces odontolyticus infection in the mandible. Diagnosis required incisional biopsy, and treatment involved 12 months of oral antibiotics.


Assuntos
Actinomicose Cervicofacial/diagnóstico , Mandíbula/patologia , Actinomyces/isolamento & purificação , Actinomicose Cervicofacial/cirurgia , Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Biópsia , Criança , Diagnóstico Tardio , Feminino , Humanos , Imageamento por Ressonância Magnética , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Tomografia Computadorizada por Raios X
4.
Ann Otol Rhinol Laryngol ; 128(2): 152-156, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30371104

RESUMO

BACKGROUND:: Cervicofacial actinomycosis is an uncommon indolent infection caused by Actinomyces spp that typically affects individuals with innate or adaptive immunodeficiencies. Soft tissues of the face and neck are most commonly involved. Actinomyces osteomyelitis is uncommon; involvement of the skull base and temporal bone is exceedingly rare. The authors present a unique case of refractory cervicofacial actinomycosis with development of skull base and temporal bone osteomyelitis in an otherwise healthy individual. METHODS:: Case report with literature review. RESULTS:: A 69-year-old man presented with a soft tissue infection, culture positive for Actinomyces, over the right maxilla. Previous unsuccessful treatment included local debridement and 6 weeks of intravenous ceftriaxone. He was subsequently treated with conservative debridement and a prolonged course of intravenous followed by oral antibiotic. However, he eventually required multiple procedures, including maxillectomy, pterygopalatine fossa debridement, and a radical mastoidectomy to clear his disease. Postoperatively he was gradually transitioned off intravenous antibiotics. CONCLUSIONS:: Cervicofacial actinomycosis involves soft tissue surrounding the facial skeleton and oral cavity and is typically associated with a history of mucosal trauma, surgery, or immunodeficiency. The patient was appropriately treated but experienced disease progression and escalation of therapy. Although actinomycosis is typically not an aggressive bacterial infection, this case illustrates the need for prompt recognition of persistent disease and earlier surgical intervention in cases of recalcitrant cervicofacial actinomycosis. Chronic actinomycosis has the potential for significant morbidity.


Assuntos
Actinomicose Cervicofacial/microbiologia , Processo Mastoide/microbiologia , Osteomielite/microbiologia , Base do Crânio/microbiologia , Actinomicose Cervicofacial/tratamento farmacológico , Actinomicose Cervicofacial/cirurgia , Administração Intravenosa , Administração Oral , Idoso , Antibacterianos/uso terapêutico , Terapia Combinada , Desbridamento , Progressão da Doença , Humanos , Masculino , Mastoidectomia , Maxila/cirurgia , Osteomielite/tratamento farmacológico , Osteomielite/cirurgia , Fossa Pterigopalatina/cirurgia , Resultado do Tratamento
5.
J Craniofac Surg ; 28(3): e269-e271, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28468217

RESUMO

Actinomycosis, an infectious bacterial disease caused by Actinomyces species, is very rare and is characterized by contiguous spreading, subacute to chronic granulomatous inflammation and the formation of multiple abscesses and sinus tracts that may discharge sulfur granules. Actinomycosis that presents on the skin without endogenous origin is called primary cutaneous actinomycosis, and the occurrence and treatment of primary cutaneous actinomycosis is rarely reported. This report describes the treatment of primary cervicofacial actinomycosis with a literature review, and emphasizes the importance of surgical option for complete remission of the disease.


Assuntos
Actinomyces/isolamento & purificação , Actinomicose Cervicofacial/cirurgia , Procedimentos Cirúrgicos Dermatológicos/métodos , Dermatopatias Bacterianas/cirurgia , Actinomicose Cervicofacial/diagnóstico , Actinomicose Cervicofacial/microbiologia , Idoso , Biópsia , Feminino , Humanos , Indução de Remissão , Pele/diagnóstico por imagem , Pele/microbiologia , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Bacterianas/microbiologia , Tomografia Computadorizada por Raios X
6.
BMC Infect Dis ; 16(1): 417, 2016 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-27526941

RESUMO

BACKGROUND: Paediatric cervicofacial actinomycosis is a rare infectious disease caused by Actinomyces spp. and usually presents as a chronic, suppurative and granulomatous inflammation with a propensity to mimic malignant conditions. CASE PRESENTATION: We discuss the case of an 11-year-old African female who presented with a chronic disfiguring cervical mass evolving over a 9 months period for which she had several unyielding consultations. Appropriate clinical and para-clinical evaluations were paramount to the diagnosis of an Actinomyces infection. We review the literature on its epidemiology, clinical presentation, diagnosis, treatment and prognosis. CONCLUSION: Actinomycosis still poses a diagnostic challenge. It is important for clinicians to consider the possibility of such rare infections in apparently malignant looking masses and also in lesions not responding to several antimicrobial treatments. The condition generally carries a good prognosis if recognised early and histopathological diagnosis is the gold standard.


Assuntos
Actinomicose Cervicofacial/diagnóstico , Actinomicose Cervicofacial/tratamento farmacológico , Actinomicose Cervicofacial/cirurgia , Administração Intravenosa , Antibacterianos/uso terapêutico , Criança , Diagnóstico Diferencial , Ertapenem , Feminino , Humanos , Penicilinas/uso terapêutico , Prognóstico , beta-Lactamas
7.
BMJ Case Rep ; 20162016 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-27033296

RESUMO

Actinomyces spp are found in the flora of the oral cavity and vagina and may cause infection with abscess formation and draining sinuses. Cervicofacial manifestations of actinomycosis involve head and neck soft tissue, however, spread to the cervical spine is rare. We report a case of an 8-year-old boy, presenting with neck pain for 1 month and denying a history of trauma or procedures. Radiography revealed an ulceration of the posterior oropharyngeal mucosa with a defect extending to the C1-C2 vertebra, mimicking a neoplastic process. The patient underwent laryngoscopy and multiple biopsies were taken from the ulcer and bone, showing severe osteomyelitis and intraosseous filamentous organisms, morphologically consistent with Actinomyces spp. The boy received long-term antibiotics with response to treatment. Actinomycosis has rarely been reported in the cervical vertebrae of paediatric patients. This should be considered as a differential diagnosis for such a presentation as prompt antibiotic treatment may be lifesaving.


Assuntos
Actinomicose Cervicofacial/diagnóstico , Osteomielite/diagnóstico , Actinomicose Cervicofacial/tratamento farmacológico , Actinomicose Cervicofacial/cirurgia , Antibacterianos/uso terapêutico , Criança , Diagnóstico Diferencial , Humanos , Laringoscopia , Masculino , Osteomielite/tratamento farmacológico , Resultado do Tratamento
10.
Med Oral Patol Oral Cir Bucal ; 18(4): e627-32, 2013 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-23722146

RESUMO

OBJECTIVES: Actinomycosis is a chronic suppurative granulomatous infection caused by the Actinomyces genus. Orocervicofacial actinomycosis is the most common form of the disease, seen in up to 55% of cases. All forms of actinomycosis are treated with high doses of intravenous penicillin G over two to six weeks, followed by oral penicillin V. Large studies on cervicofacial actinomycosis are lacking. Therefore proper guidelines for treatment and treatment duration are difficult to establish. The aim of this study is to establish effective treatment and treatment duration for orocervicofacial actinomycosis. STUDY DESIGN: A Pubmed and Embase search was performed with the focus on treatment and treatment duration for cervicofacial actinomycosis. The hospital records of all patients presenting to our department with head and neck infection from January 2000 to December 2010 were reviewed, retrospectively. The following data were collected: age, gender, clinical presentation, aetiology, duration of symptoms, microbiological findings, treatment, and duration of treatment. The treatment and treatment duration is subsequently compared to the literature. RESULTS: The literature search provided 12 studies meeting the inclusion criteria. All studies were retrospective in nature. Penicillin or amoxicillin/clavulanic acid are the preferred antibiotic regimens found in the literature. Most of our patients were treated with a combination of penicillin G 12 million units/day and metronidazol 500 mg 3/day, most commonly for a duration of 1 - 4 weeks, being shorter than the 3 - 52 weeks reported in the literature. CONCLUSION: When actinomycosis is suspected, our review has shown that a surgical approach in combination with intravenous penicillin and metronidazol until clinical improvement is seen, followed by oral antibiotics for 2 - 4 weeks is generally efficient.


Assuntos
Actinomicose Cervicofacial/terapia , Actinomicose Cervicofacial/cirurgia , Antibacterianos/uso terapêutico , Terapia Combinada , Humanos , Estudos Retrospectivos
11.
BMJ Case Rep ; 20132013 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-23580677

RESUMO

Human actinomycosis is a rare soft tissue infection caused by Gram-positive, anaerobic bacteria Actinomyces israelii, a commensal of the oral cavity. The major clinical forms of actinomycosis are cervicofacial, thoracic, abdominal and pelvic forms. The cervicofacial region is most commonly affected. Actinomycosis is sometimes difficult to diagnose and it should be borne in mind in the differential diagnosis of numerous infectious and non-infectious diseases. We report a patient who came with tooth pain and extra-oral swelling which later on presented as multiple draining sinuses. Our initial suspicion was dento-alveolar abscess or osteomyelitis. However, a culture of the discharge and subsequent biopsy revealed actinomycetes, confirming cervicofacial actinomycosis, but presenting itself not as the typical 'lumpy jaw'. The patient was successfully treated conservatively with a short but intensive antibiotic course.


Assuntos
Actinomicose Cervicofacial/diagnóstico , Actinomicose Cervicofacial/tratamento farmacológico , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Penicilina G/uso terapêutico , Actinomicose Cervicofacial/cirurgia , Terapia Combinada , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Panorâmica
12.
Rev. esp. cir. oral maxilofac ; 33(2): 75-78, abr.-jun. 2011.
Artigo em Espanhol | IBECS | ID: ibc-88095

RESUMO

Objetivos: Presentar un caso de actinomicosis cervicofacial tras cirugía ortognática. Material y métodos: Varón de 32 años, intervenido de cirugía ortognática bimaxilar en otro centro, que al cabo de varias semanas comienza a desarrollar una masa laterocervical derecha con signos de inflamación local intermitente. Las pruebas de imagen cervical informan de tumoración sólida o vascular. La citología refiere linfocitosis. Resultados: Al cabo de 2 años es intervenido y se le realiza una incisión tipo Risdon cervical, en la que se observa un granuloma caudal a la celda submaxilar derecha y una fístula con trayecto hasta el nivel del ángulo mandibular. El informe de anatomía patológica describe absceso con cambios crónicos y colonia de actinomices. Conclusiones: El diagnóstico temprano de actinomicosis cervicofacial es difícil y sólo un 10% se diagnostican en el inicio de su presentación. Aunque es un hecho infrecuente, debemos considerar la actinomicosis cervicofacial en pacientes intervenidos de cirugía ortognática que desarrollaron una masa cervical varias semanas después de la intervención(AU)


Objectives Presentation of a case of cervicofacial actinomycosis after orthognathic surgery. Material and methods A 32-year-old male underwent bimaxillary orthognathic surgery at another clinic. Several weeks after surgery, the patient developed a right lateral mass in the neck with intermittent signs of local inflammation. Cervical imaging suggested a solid or vascular tumor. The cytology revealed lymphocytosis. Results Two years after the index intervention, surgery performed through a Risdontype cervical incision revealed a granuloma in the lower right submaxillary cell with a fistula to the mandibular angle. The pathology report was consistent with chronic abscess with actinomyces colonization. Conclusions Early diagnosis of cervicofacial actinomycosis is difficult and only 10% of cases are detected at onset. Although uncommon, cervicofacial actinomycosis should be considered in patients with orthognathic surgery who develop a cervical mass in the weeks after surgery (AU)


Assuntos
Humanos , Masculino , Adulto , Actinomicose Cervicofacial/diagnóstico , Actinomicose Cervicofacial/cirurgia , Granuloma/complicações , Actinomicose Cervicofacial/fisiopatologia , Actinomicose Cervicofacial , Granuloma/cirurgia , Granuloma , Diagnóstico Precoce
13.
J Can Dent Assoc ; 76: a113, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21044422

RESUMO

Actinomycosis has increasingly been recognized as a cause of persistent or recurrent periapical disease associated with endodontic therapy. After conventional root canal therapy of the lower left first and second molars, a 24-year-old woman presented with a persistent periapical lesion associated with one of the sinus tracts. The lesion was surgically removed, and actinomycosis was diagnosed on the basis of biopsy results. The clinical and histologic features of this rare condition are discussed.


Assuntos
Actinomicose Cervicofacial/cirurgia , Abscesso Periapical/cirurgia , Actinomicose Cervicofacial/etiologia , Apicectomia , Fístula Dentária/etiologia , Fístula Dentária/microbiologia , Fístula Dentária/cirurgia , Feminino , Humanos , Abscesso Periapical/etiologia , Abscesso Periapical/microbiologia , Tratamento do Canal Radicular/efeitos adversos , Adulto Jovem
14.
Schweiz Monatsschr Zahnmed ; 119(3): 239-51, 2009.
Artigo em Francês, Alemão | MEDLINE | ID: mdl-19408527

RESUMO

Infectious diseases transmitted by actinomycosis species cause severe destructive lesions. This rare and specific infection is mainly found in the orofacial regions. Causes of any hard tissue swelling in the jaw have, thus, to be assessed carefully. When actinomycosis is identified, a surgical intervention with curettement, draining and long-term antibiosis is required. The aim of the current article is to describe two clinical cases and to show the necessity of both, microbiological and histological laboratory diagnostics, to hedge the clinic diagnosis.


Assuntos
Actinomicose Cervicofacial/tratamento farmacológico , Actinomicose Cervicofacial/cirurgia , Infecção Focal Dentária/complicações , Actinomyces/isolamento & purificação , Actinomicose Cervicofacial/microbiologia , Adulto , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Clindamicina/uso terapêutico , Drenagem , Feminino , Humanos , Masculino , Abscesso Periapical/complicações , Adulto Jovem
15.
Br Dent J ; 206(4): 201-2, 2009 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-19247335

RESUMO

Actinomycosis is a suppurative and often chronic bacterial infection most commonly caused by Actinomyces israelii. It is rare in dental practice. In the case reported the patient presented to his general dental practitioner complaining of a loose upper denture. This was found to be due to an actinomycotic infection which had caused extensive destruction and sequestration of the maxillary and nasal bones and subsequent deviation of the nasal septum.


Assuntos
Actinomicose Cervicofacial/cirurgia , Doenças Maxilares/cirurgia , Actinomicose Cervicofacial/diagnóstico por imagem , Actinomicose Cervicofacial/tratamento farmacológico , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Clindamicina/uso terapêutico , Diagnóstico Diferencial , Humanos , Masculino , Doenças Maxilares/diagnóstico por imagem , Doenças Maxilares/tratamento farmacológico , Osso Nasal/patologia , Osso Nasal/cirurgia , Deformidades Adquiridas Nasais/etiologia , Doenças Nasais/complicações , Doenças Nasais/tratamento farmacológico , Doenças Nasais/cirurgia , Tomografia Computadorizada por Raios X
16.
Kulak Burun Bogaz Ihtis Derg ; 18(4): 257-9, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19052497

RESUMO

Actinomycosis of the submandibular gland is unusual. A 55-year-old male presented with a right, painless submandibular mass of four-year duration. Physical examination revealed a 4 x 3-cm mass in the submandibular region. Ultrasonography-guided fine needle aspiration from the lesion showed microorganisms compatible with actinomyces colonies in the glandular tissue. The diagnosis was made as actinomycosis of the right submandibular gland accompanied by sialolithiasis. The patient was treated with penicillin G (10 million U/day) for three months, followed by 3 g/day oral penicillin for six months. After this medication, physical examination showed no decrease in the size of the mass and the clinical features remained unchanged. Submandibular gland excision under general anesthesia was performed.


Assuntos
Actinomicose Cervicofacial/complicações , Cálculos das Glândulas Salivares/complicações , Doenças da Glândula Submandibular/diagnóstico , Actinomyces/isolamento & purificação , Actinomicose Cervicofacial/diagnóstico , Actinomicose Cervicofacial/tratamento farmacológico , Actinomicose Cervicofacial/cirurgia , Antibacterianos/uso terapêutico , Biópsia por Agulha Fina , Humanos , Masculino , Pessoa de Meia-Idade , Penicilina G/uso terapêutico , Cálculos das Glândulas Salivares/diagnóstico , Cálculos das Glândulas Salivares/tratamento farmacológico , Cálculos das Glândulas Salivares/cirurgia , Glândula Submandibular/diagnóstico por imagem , Glândula Submandibular/microbiologia , Glândula Submandibular/patologia , Glândula Submandibular/cirurgia , Doenças da Glândula Submandibular/tratamento farmacológico , Doenças da Glândula Submandibular/cirurgia , Tomografia Computadorizada por Raios X
18.
Fogorv Sz ; 100(4): 135-40, 2007 Aug.
Artigo em Húngaro | MEDLINE | ID: mdl-17915488

RESUMO

Actinomycosis is a chronic, specific inflammation which is characterized by suppuration, abscess formation, tissue fibrosis and granuloma formation. Actinomycosis has three main forms (cervicofacial, which is the most frequent, approximately 60%, pulmonary and abdominal), but other regions of the body can be involved, too (e.g. neck, ovaries, bones), that is why its differential diagnosis becomes more and more relevant. Regarding its treatment, the majority of authors recommends the combination of surgical and antibiotic treatment. The authors of this article present a typical case of cervicofacial actinomycosis, in which the authors used the combination of surgical and antibiotic treatment. As a result of the treatment the healing process was completed successfully and without complications.


Assuntos
Actinomicose Cervicofacial/diagnóstico , Actinomicose Cervicofacial/terapia , Antibacterianos/uso terapêutico , Actinomicose/diagnóstico , Actinomicose/terapia , Actinomicose Cervicofacial/complicações , Actinomicose Cervicofacial/tratamento farmacológico , Actinomicose Cervicofacial/cirurgia , Idoso , Cloranfenicol/uso terapêutico , Clindamicina/uso terapêutico , Fístula Cutânea/microbiologia , Diagnóstico Diferencial , Granuloma/microbiologia , Humanos , Masculino , Penicilina G/uso terapêutico , Penicilina V/uso terapêutico , Tetraciclina/uso terapêutico , Resultado do Tratamento
19.
Acta Otolaryngol ; 127(5): 550-2, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17453484

RESUMO

Actinomycosis is a rare chronic granulomatous disease that involves the upper airway and gastrointestinal tract. Approximately 40-55% of actinomycosis comprises the cervicofacial form. It presents a challenging clinical diagnostic dilemma because of variable presentations in the head and neck. Herein, we report a rare case of actinomycosis presenting as a vocal cord nodule in a healthy 21-year-old man who was not immunocompromised and had no other known medical disease.


Assuntos
Actinomicose Cervicofacial/diagnóstico , Doenças da Laringe/diagnóstico , Prega Vocal , Actinomicose Cervicofacial/patologia , Actinomicose Cervicofacial/cirurgia , Adulto , Combinação Amoxicilina e Clavulanato de Potássio/administração & dosagem , Biópsia , Diagnóstico Diferencial , Rouquidão/etiologia , Humanos , Doenças da Laringe/patologia , Doenças da Laringe/cirurgia , Laringoscopia , Masculino , Cuidados Pós-Operatórios , Prega Vocal/patologia , Prega Vocal/cirurgia
20.
J Laryngol Otol ; 120(8): 681-3, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16716241

RESUMO

Actinomycotic infections of the cervicofacial region are not uncommon. However, actinomycosis of the tongue is rare. A mass that may mimic both benign and malignant neoplasms can be seen at clinical presentation and may mislead the diagnosis. We report a patient who presented with a tumour-like tongue mass causing speech disturbance, diagnosed as actinomycosis.


Assuntos
Actinomyces , Actinomicose Cervicofacial/diagnóstico , Doenças da Língua/diagnóstico , Actinomicose Cervicofacial/tratamento farmacológico , Actinomicose Cervicofacial/cirurgia , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Terapia Combinada , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Doenças da Língua/microbiologia , Doenças da Língua/cirurgia , Neoplasias da Língua/diagnóstico
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