Cases reported "Actinomycosis"

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1/19. Pelvic actinomycosis presenting as malignant large bowel obstruction: a case report and a review of the literature.

    actinomycosis is an infrequent chronic infectious disease. In most cases the diagnosis is made postoperatively because of its unusual clinical presentation. Moreover, abdominal actinomycosis may mimic cancer, inflammatory bowel disease, or diverticulitis. Delay in diagnosis leading to inadequate management and unnecessary procedures has been reported. We report the case of a 49-year-old woman with large bowel obstruction secondary to extensive pelvic actinomycosis involving the rectosigmoid and cecum. She required emergency surgery, which involved both resection and colostomy. A review of the literature on abdominal actinomycosis during the last 50 years is also reported. Rarely has emergency surgery been described in this condition. Although the incidence of actinomycosis has decreased, the abdominal-pelvic form has been increasing over the past 10 years secondary to increased prolonged use of the intrauterine device. As the clinical spectrum of actinomycosis has dramatically changed, so have the therapeutic considerations. Aggressive surgical management in advanced cases with multiorganic involvement seems to have reemerged in recent years. Consideration of actinomycosis in a woman with prolonged use of an intrauterine device and symptoms of bowel obstruction could help to improve the preoperative diagnosis and management of this rare disease.
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2/19. Primary renal and retroperitoneal actinomycosis.

    A case of the rare condition of renal and retroperitoneal actinomycosis is presented. The clinical and imaging (ultrasonography and computed tomography) findings are described and attention is drawn to the diagnostic difficulties in this rare disease.
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3/19. Primary vesical actinomycosis: a case diagnosed by multiple transabdominal needle biopsies.

    Primary vesical actinomycosis is an extremely rare disease. In most cases it is misdiagnosed as vesical or urachal tumor and usually diagnosed through post-operative pathologic confirmation. Here we report a case of primary vesical actinomycosis confirmed by preoperative repeated multiple transabdominal biopsies. The patient was a 49-yr-old woman who presented with frequency, dysuria, and intermittent gross hematuria for 2 months. Computed tomography and cystoscopic examination showed broad-based, edematous, and protruding mass at the dome and anterior portion of the bladder. The clinical and imaging findings of the patient initially suggested vesical malignancy. Transurethral resection and multiple biopsies of the mass were performed. Pathologic examination demonstrated fibrosis with chronic inflammation. We performed repeated transabdominal multiple needle biopsies for further pathologic confirmation. Histopathologic examination demonstrated typical sulfur granules, which were consistent with actinomycosis.
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4/19. Mesenteric actinomycosis with retroperitoneal involvement.

    Mesenteric or retroperitoneal actinomycosis is an extremely rare disease. The international databases have revealed only 10 cases affecting the mesenterium and another 52 cases affecting the retroperitoneum. We report a 78-year-old female who was admitted with complaints of abdominal pain. Laboratory examination revealed anemia and the clinical examination revealed an irregular mass in the abdomen. Ultrasound and computed tomography (CT) scans showed a solid mass in the mesenteric-retroperitoneal region. biopsy of the nonresectable mass revealed the presence of chronic inflammation in the mesenteric area with actinomyces colonies. The patient was treated with oral amoxicillin, 500 mg every 6 hours for 6 months. The symptoms disappeared, but the mesenteric-retroperitoneal mass remains, but smaller in size. Based on the review of the literature and the case reported here, we conclude that mesenteric-retroperitoneal actinomycosis is difficult to diagnose by means of noninvasive techniques as it can masquerade as a malignant process. An accurate diagnosis is always obtained in a histological or microbiological examination, often requiring surgical intervention. Treatment with penicillin has proven to be effective.
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5/19. Primary endobronchial actinomycosis associated with broncholithiasis.

    Primary endobronchial actinomycosis is an extremely rare disease that presents with endobronchial mass. We report 2 cases of primary endobronchial actinomycosis associated with broncholithiasis. There was no foreign body material, suggesting that these broncholiths were formed endogenously. Even though it is very rare, endobronchial actinomycosis should be included in the differential diagnosis of calcified endobronchial mass, especially when there is no clinical or radiological evidence of a granulomatous infection, such as tuberculosis, and the yellowish materials obstructing the bronchi are seen during bronchoscopy.
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6/19. Intraoral actinomycotic lesion: a case report.

    actinomycosis often referred to, as the chameleon of the head and neck pathology is a rare disease, uncommon in children. This article refers to a case of intraoral actinomycotic lesion of the palate in a child following a rare aetiology, the relevant literature, clinical course and its successful resolution.
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7/19. Actinomycotic liver abscess. Case report and review of the literature.

    actinomycosis is a chronic suppurative, granulomatous disease, which is characterized clinically by extensive necrosis and abscess formation, and histologically by the presence of the so-called "sulphur granules". actinomycosis is generally classified as being of cervicofacial, thoracic or abdominal type. The objective of this study is the presentation of a case of actinomycotic liver abscess that we encountered in our department 5 years ago, along with a brief review of this rare disease. A 39-year-old male non-Greek Caucasian patient presented with high fever, malaise, anorexia, vomiting after food ingestion and right upper quadrant pain. Leucocytosis with a left shift was present, and ultrasonography demonstrated a mass of mixed composition in the anterior part of the right hepatic lobe, measuring 6.8 x 4.6 cm, suggestive of an abscess or haemangioma. MRI scan confirmed the presence of a space-occupying lesion, suggestive of an abscess. The patient was submitted to surgical drainage of the hepatic abscess. The culture of the purulent material was found to be sterile, while the histochemical examination of the specimen demonstrated the presence of actinomycosis. The patient had an uneventful postoperative course and after discharge received prolonged chemoprophylaxis. Actinomycotic liver abscess is a very rare clinical entity, and only 57 cases have been reported in the English literature. Due to the rarity of the disease and the limited number of reported cases, we considered it useful to report this case.
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8/19. actinomycosis in neck glands.

    A middle aged woman presented with right submandibular swelling, fever off and on and anemia. Excisional biopsy of the gland showed actinomycosis. It is a rare disease in the neck. Patient was treated with high doses of parenteral pencillins followed by three months course of oral Doxycyclines. The patient was followed up to six months and she was symptom free. In this case report the disease is elaborated and literature is reviewed.
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9/19. Actinomycotic suppurative thyroiditis in a child.

    AIM: To present a rare case of actinomycotic suppurative thyroiditis in an infant with provision of the etiology, pathogenesis, clinical findings and treatment of this rare disease. DESIGN: A report of an 18-month-old female infant who presented with fever, erythema, induration and tenderness of the neck. The patient had the diagnosis of acute suppurative thyroiditis after a series of laboratory evaluation. RESULT: She was treated successfully with surgical debridement and intravenous penicillin g. CONCLUSION: Although rare, actinomyces spp. should be considered in the etiology of acute suppurative thyroiditis. Because of its fastidious nature the probability of positive culture is low, thus, the microbiology laboratory should be called in advance to make preparations before culture and transport.
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10/19. actinomycosis esophagitis in a patient with persistent dysphagia.

    Many causes of esophagitis exist in immunocompromised patients. Uncommon pathogens must be considered to facilitate timely and appropriate therapy. A limited number of cases of esophageal actinomycosis have been reported. This report describes an unusual case of esophageal actinomycosis in a patient with persistent dysphagia. The broad differential may have delayed definitive diagnosis in the case study patient. biopsy and culture are essential for accurate diagnosis. Although actinomycosis is a rare disease, it should be included in the differential diagnosis of patients presenting with oral or esophageal complaints. It may also be considered as an opportunistic infection in immunocompromised patients. The treatment of choice is parenteral penicillin g, 18 to 24 million units for 2 to 6 weeks followed by oral therapy for 6-12 months.
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