Actinomycosis In Children Research Articles

Skin and Soft Tissue Actinomycosis in Children and Adolescents.

Pediatric actinomycosis studies are limited to case reports or small case series. In this retrospective cohort study, we aimed to describe characteristics of skin and soft tissue actinomycosis in adolescents and children. We conducted the study from January 2019 to December 2022, including patients ≤21 years of age with at least 1-year follow-up data. All clinical cultures obtained under sterile conditions with Actinomyces growth were included. One hundred four patients met inclusion criteria; median age 19 (interquartile range: 17-20) years, 68.3% female, 46.2% Black and 47.1% Hispanic. The median antibiotic treatment duration was 10 (7-10) days, and majority of patients received treatment with non-first-line Actinomyces antibiotics. Infectious disease consultation was requested for only 7 patients during their initial skin and soft tissue actinomycosis treatment. One-third of the patients with skin and soft tissue actinomycosis had documented recurrence within a median of 10 (interquartile range: 6-16) months of the initial episode. Monobacterial culture growth (85.7% vs. 63.8%, P = 0.02), patients with body mass index >25 (75% vs. 52.6%, P = 0.04) and patients with prior abscess in the same area (18.8% vs. 51.4%, P = 0.001) were significantly higher in patients with recurrent actinomycosis compared to the nonrecurrent group. In a univariate logistic regression model, they were found to be significantly associated with recurrence; monobacterial growth [odds ratio (OR): 3.4; 95% confidence interval (CI): 1.2-9.9], body mass index >25 (OR: 2.7; 95% CI, 1.1-7.0) and prior abscess (OR: 4.6; 95% CI: 1.9-11.2). Our study results highlight the importance of considering Actinomyces species in skin and soft tissue infections, especially in recurrent ones, and risk factors for recurrence. Suboptimal antibiotic utilization, very low numbers of consultations with infectious diseases and high recurrence rate suggest that providers should be informed and updated regarding this rare but hard-to-treat infection.

Paediatric actinomycosis: A 16-year, single-institution retrospective review of cases.

Actinomycosis is a rare subacute to chronic granulomatous infection which can mimic other infectious or malignant diseases. This study examined the epidemiology and treatment outcome of actinomycosis in children. A retrospective study on children admitted for actinomycosis in a tertiary paediatric hospital in Singapore, from January 2004 to December 2020. Clinical profile, therapeutic interventions and outcomes were examined. A total of 10 patients were identified; 7 were female. The median age at first presentation was 9.8 years (range 4.7-15.7). The most common presenting symptom was fever (n = 6, 60%), followed by facial or neck swelling (n = 3, 30%) and ear pain (n = 3, 30%). Actinomycosis occurred predominantly in the orocervicofacial region (n = 6, 60%). Four patients (40%) had preceding dental infections in the form of dental caries or gingivitis. One patient had poorly controlled insulin-dependent diabetes mellitus. Actinomycosis was confirmed via culture in four patients, histopathology in four patients and both methods in two patients. All except one patient (n = 9, 90%) underwent surgical procedures. All patients received ampicillin or amoxicillin/clavulanate or other beta-lactams, for a median duration of 6.5 months (range 1.5-14). Complications included osteomyelitis (n = 4, 40%), mastoiditis (n = 2, 20%), brain abscess (n = 1, 10%) and recurrent neck abscess (n = 1, 10%). There was no mortality and all patients achieved complete resolution. Paediatric actinomycosis was rare in our 16-year review, but had a high complication rate. It can occur in immunocompetent patients, and dental infection was the predominant risk factor identified. Prognosis was excellent after surgical intervention and appropriate antimicrobial therapy.

First case of the succesful treatment of actinomicosis of the knee in a child

Objectives. Actinomycosis in children has not been studied enough, the number of publications is limited. Actinomycosis of the knee joint is very rare, the disease mimics tuberculosis or malignant neoplasms, which can lead to late diagnosis and inadequate treatment. Materials and methods. We report on the first case of an 8-year-girl with actinomycosis knee. Diagnosis is based on histological examination. Results. Surgical resection of infected tissue and longterm antibiotic therapy for 4.5 months was effective in the treatment of pediatric patient with knee actinomycosis. In the scientific literature no such clinical case was found.Сonclusion. Case of successful treatment of pediatric patient with knee actinomycosis is presented for the first time.

Actinomyces and Nocardia infections in chronic granulomatous disease

Objective:Chronic granulomatous disease (CGD) is an inherited disorder of the Nicotinamide adenine dinucleotide phosphate reduced oxidase complex characterized by recurrent bacterial and fungal infections. Disseminated infection by combination of opportunistic agents is being increasingly reported in CGD patients. We presented in the retrospective review of medical records, the etiology, presentation, clinical characteristics the infections detected, predisposing condition and outcome of nocardiosis and actinomycosis involved in a group of pediatric patients diagnosed with CGD.Materials and Methods:The clinical presentation of CGD-related infections was reviewed retrospectively from the medical records of all 12 patients with CGD. We studied respectively 12 patients between 2001 and 2008, and we analyzed two pediatric patients with CGD who acquired Nocardia and Actinomyces infections, and their clinical and microbiological characteristics were described. The material for investigations was collected from scrapings, crusts, pus from subcutaneous abscesses or exudation from sinus tracts, surgical debridement, and biopsy specimens. The microbiological diagnosis was determined by biochemical tests, histology, microscopy, and culture of clinical samples.Results:The medical records of 12 diagnosed CGD patients with suspected nocardiosis or actinomycosis were reviewed. One patient was diagnosed with actinomycosis and one patient with nocardiosis. Patients consisted of seven males and five females with ranging ages of 3 to 18 years. Nocardiosis and actinomycosis isolated in the two patients were confirmed by histology and culture methods. Neutrophil oxidative burst were absent (NBT=0) in both patients. The most common manifestations of CGD due to fungal infections, actinomycosis, and nocardiosis were osteomyelitis (42.8%), pulmonary infections (28.6%), lymphadenopathy (14.3%), and skin involvement (14.3%) during their illness.Conclusion:Nocardiosis and actinomycosis in children indicate the need for evaluation for an underlying immunological deficiency. Early diagnosis remains critical for decreased morbidity and occasional mortality. Physicians caring for patients with CGD should maintain a high index of suspicion for nocardiosis and actinomycosis especially if work up for TB and fungal infections are negative.

Case report: actinomycosis of the appendix—an unusual cause of acute appendicitis in children

Abdominal actinomycosis in children is a rare disease, which is occasionally found on histologic examination after an operation for acute appendicitis. Because of its nonspecific clinical and radiological signs and symptoms and low prevalence, the diagnosis is hardly ever made before the patient undergoes an operation and tissue is available for pathologic evaluation. When the diagnosis is made, the patient should be treated with the appropriate long-term antibiotics. With antibiotic therapy, the prognosis is favorable.We describe a 13-year-old girl who presented with acute appendicitis and was found to have abdominal actinomycosis after undergoing open appendectomy, which was treated successfully with penicillin and piperacillin-tazobactam.

Thoracic Actinomycosis in Children

Thoracic actinomycosis is uncommon, indolent, and often not considered in children with chest wall masses, pneumonia, or empyema. We present a 27-month-old girl without risk factors for thoracic actinomycosis whose initial diagnosis was malignancy. She recovered completely after lobectomy, debridement, and antimicrobial therapy. Literature review since 1975 identified 54 additional cases; most were male, older, and had underlying risk factors.

Post varicella hepatic actinomycosis in a 5-year-old girl mimicking acute abdomen

Actinomycosis is an indolent, slowly progressive infection caused by gram-positive, anaerobic or microaerophilic bacteria. Hepatic involvement is rare and generally secondary to abdominal or thoracic actinomycosis. Hepatic actinomycosis in children may mimic a wide variety of diseases and thus make the diagnosis much more challenging. Here, we report a 5-year-old girl with apparently primary hepatic actinomycosis mimicking acute abdomen 2 weeks after varicella. The diagnosis was made by ultrasonic guided fine needle aspiration biopsy of a hypoechoic lesion of 3.5 cm diameter in the liver showing sulfur granules surrounded by neutrophils. Hepatic actinomycosis should be taken into account when evaluating acute abdomen symptoms in children.

An investigation of the significance of Actinomycosis in tonsil disease

The objective of the study was to establish the incidence of Actinomycosis in the tonsils of children undergoing tonsillectomy or adenotonsillectomy, and to evaluate its role in clinical tonsillar disease. This was a prospective controlled study done at the Red Cross Children's Hospital in Cape Town, South Africa over an 8-month period and included all children undergoing tonsillectomy or adenotonsillectomy. All resected tonsils were examined for the presence of Actinomycosis and any signs of significant cryptitis or active tonsillitis. A comparison was made in the incidence of Actinomycosis in children with obstructive sleep apnoea, recurrent tonsillitis or obstructive sleep apnoea and recurrent tonsillitis. The data was further analysed to determine the statistical significance of the association between Actinomycosis of the tonsils and age, sex and histopathological and clinical diagnosis. A total of 344 tonsils were analysed on 172 patients. We found 20 patients (11.6%) with Actinomycosis in the tonsils. The mean age of patients with Actinomycosis was 7.25 years and without Actinomycosis was 5.4 years (p=0.002). Most specimens (16) had no evidence of tissue reaction to Actinomyces, and their presence was found to be due to colonisation of the tonsils only. Actinomycosis was present in 11% of patients with obstructive sleep apnoea, 11% of patients with recurrent tonsillitis and in 9% with obstructive sleep apnoea and recurrent tonsillitis. The difference in incidence of Actinomycosis between these three groups (p=0.94), and between the recurrent tonsillitis group alone compared to the obstructive group (p=0.83), was not statistically significant. There was therefore no statistical significance found between Actinomyces and OSA+/- recurrent tonsillitis. There was no correlation found between the presence of tonsillar Actinomycosis and recurrent tonsillitis and/or obstructive tonsillar hypertrophy. Histopathologic findings showed no evidence of tissue reaction to Actinomyces and its presence was found to be due to colonisation of the tonsils only. The series did however show a statistically significant correlation between Actinomycosis colonisation and age with Actinomycosis being more common in older children, especially those over 5 years of age.

Pulmonary actinomycosis in children

The radiological features of three cases of pulmonary actinomycosis in children are presented. Two of the cases had the classical roentgen features of chronic consolidation with overlying rib periostitis. The third had non specific consolidation but demonstrated extension through the diaphragm. Two of our cases were mentally subnormal children in institutional care. Their pulmonary pathology is almost certainly attributal to poor dental hygiene, a constant problem in this group of children. Hence, although pulmonary actinomycosis is rare in the general populus, we suggest it might be suspected more often in the subnormal group when chronic consolidation is present.

Two cases of actinomycosis in children : J. Virgala, R. Prekop and P. Beno. Cs. pediatrie. 25:142–144 (March), 1970

Two cases of actinomycosis in children : J. Virgala, R. Prekop and P. Beno. Cs. pediatrie. 25:142–144 (March), 1970

Two cases of thoracic actinomycosis in children.

Two cases of thoracic actinomycosis in children.

ACTINOMYCOSIS IN CHILDHOOD

In the human being, actinomycosis is primarily a disease of early adult life. That children are rarely affected is evidenced by the fact that many textbooks on pediatrics do not even mention the disease, and those that include it give only meager descriptions. In most of the reported cases of the infection in children, the disease was well advanced when recognized, and with few exceptions it progressed to a fatal termination. Fourteen cases of actinomycosis affecting children aged from 2 to 15 years are reported herewith. The clinical history, symptoms, physical conditions, diagnosis and treatment of actinomycosis in children are similar to those related to the infection in adults. These data, as they pertain to the cervicofacial group, are reviewed in a study of 107 cases made by New and Figi¹in 1923. The reader's attention is directed to this article for detailed data. The children in this series