Cases reported "Actinomycosis"

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1/166. Childhood actinomycosis. Report of 3 recent cases.

    Three cases of childhood actinomycosis are reported, 2 with the commonest presentation of cervicofacial abscess and the third with a rarely reported superficial chest wall abscess. The importance of prompt bacteriological diagnosis and adequate treatment with surgical drainage and chemotherapy is stressed. Though in adults males are affected more frequently than females, the sexes are probably equally affected in childhood.
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2/166. actinomycosis of the central nervous system: surgical treatment of three cases.

    Three cases of actinomycotic brain infection are described, 2 of which manifested as cerebral abscess, the third as epidural empyema. Complete resolution of the infection was always achieved by means of surgical treatment and prolonged antibiotic therapy. The cases reported emphasize the importance of a combined approach in the treatment of this unusual cause of brain infection.
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3/166. Pelvic actinomycosis. Is long-term antibiotic therapy necessary?

    OBJECTIVE: To describe 11 cases of actinomycosis and analyze whether long-term antibiotic use in necessary. STUDY DESIGN: Analysis of 11 cases of pelvic actinomycosis diagnosed and treated during the last nine years. Four patients had an intrauterine device (IUD) for 6-20 years, three patients had an IUD for 3-5 years, and four patients had no known etiology. In most patients the symptoms lasted from several days to one month. The actinomycotic lesions involved one or both ovaries in all 11 cases. In five patients the lesion extended to other areas, such as the uterus, omentum, parametrium, pelvic walls, colon, bladder, cul-de-sac and gallbladder. RESULTS: All patients underwent surgery that included removal of the lesions with the ipsilateral or both adnexa and, in specific cases, with extension of the lesions, hysterectomy, omentectomy, hemicolectomy and cholecystectomy. Confirmation of the diagnosis of actinomycosis was done by histology in all cases, and antibiotic treatment usually began 1-14 days after surgery. The drug of choice was penicillin. The duration of treatment was 12 months in 6 patients, 6 months in 3 and < or = 3 months in two. All patients were alive and well after two to nine years of follow-up. CONCLUSION: In contrast to actinomycosis at other sites, where the literature recommends antibiotic therapy for 6-12 months, pelvic actinomycosis could be a limited disease. We propose that in cases of pelvic actinomycosis where the abscess can be completely removed surgically, a shorter period of antibiotic therapy can be effective.
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4/166. Large bowel obstruction due to intrauterine device: associated pelvic inflammatory disease.

    Pelvic actinomycosis associated with the use of intrauterine contraceptive devices (IUDs) can mimic pelvic malignancy. Recognizing this rare, but not uncommon complication of IUD use can spare a patient from an extensive surgical procedure. If recognized preoperatively, a simple regimen of antibiotics can be curative; however, if symptomatic, a limited surgical procedure is warranted. We present the case of a 55-year-old woman with a slow, indolent course of partial large bowel obstruction and a history of IUD use for over 20 years. A preoperative CT scan revealed a frozen pelvis mimicking a pelvic malignancy. Exploratory laparotomy revealed a firm, indurated, fibrotic reaction in the pelvis involving the uterus, adnexa, and sigmoid colon. A diverting loop colostomy was performed, and pathology revealed sulfur granules from the extracted IUD that grew actinomyces. The patient was treated with the appropriate antibiotics, and during the takedown of the colostomy 6 months later the pelvic inflammation was completely resolved. An extensive review of the literature involving actinomycotic abscesses associated with IUD use reveals a limited number of studies reported in the general surgical literature. It behooves the general surgeon to be aware of this unusual case so that the appropriate consultation and treatment can be performed with limited morbidity to the patient.
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keywords = abscess
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5/166. Misleading diagnosis of retroperitoneal actinomycosis.

    A 34-year-old woman presented with a left-sided suprarenal space-occupying lesion on sonography. culture of material obtained during sonographic-guided puncture of the retroperitoneal lesion yielded a mixed flora of actinomyces and peptostreptococcus. Initially, a misleading diagnosis of an adrenal pheochromocytoma was initiated by highly positive metaiodobenzylguanidine scintigraphy after chemical chemistry vanillylmandelic acid (VMA) test showed elevated values for adrenaline and its derivatives. Retroperitoneal actinomycosis with yet unproven spread into thoracic and cervical compartments is a particular unusual presentation of an infection with these organisms. Because it may mimic subacute infections or malignant masses in terms of clinical and laboratory findings, radiological diagnosis of this entity may be difficult. The diagnosis was based on results of culture and the response of the patient to long-term penicillin-derivate therapy after surgical drainage of the suprarenal abscess formation.
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6/166. magnetic resonance imaging of actinomycosis presenting as pelvic malignancy.

    Pelvic actinomycosis is associated with long-standing use of an intrauterine contraceptive device and may present with clinical signs and symptoms of pelvic malignancy. diagnostic imaging can confirm the presence of a pelvic mass and tissue infiltration but findings are often non-specific. We present a case of pelvic actinomycosis with tubo-ovarian abscess in which magnetic resonance imaging demonstrated lower signal intensity tissue on T2 weighted sequences than would be typical for pelvic malignancy or infection and was useful in confirming regression of pelvic disease in response to antibiotic therapy.
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keywords = abscess
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7/166. Treatment strategy for pelvic actinomycosis: case report and review of the literature.

    BACKGROUND: Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by an anaerobic Gram positive organism actinomyces israelii usually associated with intra-uterine devices. Pelvic actinomycosis can mimick pelvic or intra-abdominal malignancy leading to mutilating surgical exeresis. RESULTS: We present a pelvic actinomycosis secondary to long-standing intra-uterine device use in a 50-year old European woman treated by intravenous antibiotic therapy, and then by a total abdominal hysterectomy and bilateral salpingoophorectomy to free the pelvis from abscess. We point out the difficulty in diagnosis, and the importance of high-dose intravenous antibiotic therapy to reduce the very high risk for nearby pelvic structure injuries, reported in the literature, leading to post-operative morbidity.
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ranking = 0.53209102879012
keywords = abscess, intra-abdominal
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8/166. Aggressive thoracic actinomycosis complicated by vertebral osteomyelitis and epidural abscess leading to spinal cord compression.

    STUDY DESIGN: Report of a successfully diagnosed and treated case of spinal cord compression due to epidural actinomycosis. OBJECTIVE: To illustrate that proper use of imaging strategy can greatly facilitate diagnosis and management of this rare condition. SUMMARY OF BACKGROUND DATA: Spinal actinomycosis causing epidural abscess and significant spinal cord compression is an uncommon condition. Although diagnosis is difficult, favorable results are widely reported when specific therapy is instituted. methods: A 32-year-old Chinese man had extensive dorsal thoracic soft tissue swelling and lower limb weakness. Collapse of the T5 vertebral body was found on plain radiographs with mediastinal infiltrates on chest radiograph. It took magnetic resonance imaging (MRI) to fully delineate the epidural abscess and dorsal muscular abscesses, which were not depicted by computed tomographic (CT) scan. diagnosis was made by examination of CT-guided aspirate and tissue recovered during surgery by a microbiologist. The patient received high-dose intravenous penicillin and prompt spinal decompression once diagnosis of actinomycosis was confirmed. RESULTS: The dorsal muscular abscesses and upper thoracic epidural abscess resolved rapidly after intravenous antibiotics and surgical drainage. This was well documented by follow-up MRI and the full recovery of motor power and lower limb sensation in the patient. CONCLUSIONS: High clinical suspicion and proper use of imaging data led to timely diagnosis of this rare case of mediastinal, epidural, and intramuscular thoracic actinomycosis. Specific antibiotic therapy and timely, well-targeted surgical intervention greatly improve the outcome of this condition.
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ranking = 4.5
keywords = abscess
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9/166. Actinomycotic ulcer of the oral mucosa: an unusual presentation of oral actinomycosis.

    Although the oral mucosa is often the site of entry of actinomyces into the deeper tissues, actinomycosis in the oral mucosa is extremely rare. Actinomycotic lesions are usually described as either single or multiple abscesses or indurated masses with hard fibrous walls and soft central loculations. actinomyces israelii is the principal cause of human actinomycosis. We present a rare case of actinomycosis caused by actinomyces odontolyticus; it presented primarily as a long-standing ulcer of the oral mucosa mimicking a squamous cell carcinoma.
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10/166. actinomycosis mimicking a pelvic malignancy. A case report.

    BACKGROUND: Pelvic actinomycosis is difficult to diagnose preoperatively. The chronic infection is locally infiltrative and causes a profound induration of infected tissue planes. This induration, combined with absence of fever and leukocytosis, can mimic a pelvic malignancy. CASE: A 55-year-old woman was diagnosed with a pelvic mass after a two-month history of intermittent lower abdominal pain. The patient had had an intrauterine device for 12 years; it was removed two months prior to an exploratory laparotomy for the symptomatic mass. The mass was highly suggestive of colorectal cancer, with the rectosigmoid colon indurated and adherent to the uterus and sacrum. The induration of the colon extended caudally to within 3 cm of the anal verge. An abdominoperineal resection was performed along with a total abdominal hysterectomy, bilateral salpingo-oophorectomy and colostomy. pathology revealed acute and chronic endometritis, left tuboovarian abscess and extensive, acute inflammation of the rectosigmoid colon without evidence of diverticuli. actinomycosis was diagnosed based on the characteristic sulphur granules seen on hemotoxylin and eosin staining. CONCLUSION: actinomycosis can mimic pelvic and abdominal malignancies. Surgeons should be aware of this infection to potentially spare women morbidity from excessive surgical procedures.
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