Actinomyces Colonies Research Articles

Will the aging products of soil-reinforcement fibers stress plant growth and soil health?

Soil-reinforcement fibers are widely used for soil remediation and erosion prevention in ecologically vulnerable regions with sparse vegetation coverage and are incorporated into the soil for prolonged periods. However, the potential risks posed by aging fiber materials to soil health and plant growth have been largely neglected. This study explored the effects of aging solutions for polyethylene terephthalate (PET), coir, and carbon fibers on the physiological characteristics and vegetation coverage of ryegrass, as well as soil properties. Results indicated that PET and carbon fibers decreased ryegrass density and inhibited chlorophyll synthesis. All three fiber aging solutions aggravated leaf peroxidation, as represented by a sharp increase in the malondialdehyde (MDA) content. Leaf peroxidase activities improved, whereas the ascorbate peroxidase (APX) and superoxide dismutase (SOD) activities under the carbon fiber treatment were significantly lower than those under the PET and coir fiber treatments. The three fiber aging solutions significantly reduced soil H2O2 activity, improved soil leucine aminopeptidase (LAP) activity. Besides, coir fiber aging solution improved soil hemicellulose (CB) activity significantly. Aging solutions of PET and coir fibers increased the number of soil bacterial colonies, while the carbon fiber aging solution increased the number of soil actinomyces colonies. Overall, our findings demonstrate that fiber aging solutions decrease plant density, cause leaf damage, and alter soil characteristics in the short term. However, these solutions have minimal impact on soil health. The coir fiber aging solution has minimal effects on plant growth and soil properties, and is still a viable alternative to traditional non-degradable soil-reinforcing fibers.

Mandibular actinomyces osteomyelitis

Actinomycosis caused by the Actinomyces genus can affect both soft and bone tissues. Its diagnosis depends on positive culture or identification of Actinomyces colonies and sulfur granules in histological specimens. This article aims to report a clinical case of actinomycosis in the mandible. The diagnosis of actinomycosis osteomyelitis was confirmed by bone biopsy in a female with a long-standing history of generalized periodontal disease. She underwent debridement of necrotic tissue in the region, and the material was sent for histopathological analysis, which revealed chronic localized actinomycosis osteomyelitis. The patient responded well to prompt systemic antibiotics and local surgical measures with complete resolution of the infection. Clinicians should be aware of the possibility of actinomycosis arising in generalized periodontal disease and the importance of bone biopsies and cultures in arriving at a definitive and timely diagnosis. The accurate diagnosis of actinomycosis is crucial for the successful treatment outcome.

Primary vesical actinomycosis with changes of cystitis cystica presenting as bladder mass

Actinomycosis is a rare chronic granulomatous suppurative infection caused by Gram-positive bacteria. The occurrence of primary vesical actinomycosis is extremely rare and only a few cases have been reported. Pre-operative diagnosis of vesical actinomycosis is challenging as the clinical and radiological features usually point towards bladder malignancy. Therefore, in most cases, definitive diagnosis is usually made after histopathological examination of the involved tissue. A 60-year-old male presented with complaints of hematuria, burning micturition, irritative, and obstructive urinary symptoms for 15 days. USG revealed a large soft-tissue mass having a polypoidal intraluminal and extraluminal component and involving the right posterolateral urinary bladder wall. CT scan showed a large irregular soft-tissue mass with multiple cystic lesions involving the right lateral wall of the urinary bladder. Transurethral resection of bladder mass biopsy was performed and the histopathological examination showed bacterial colonies of Actinomyces with changes of cystitis cystica. The patient was treated with amoxicillin and potassium clavulanate for 3 months. Actinomycosis should be kept as a rare differential diagnosis in cases presenting as bladder mass. The diagnosis is most commonly made by histopathology and may need a repeat biopsy to arrive at the correct diagnosis. The patient should be treated by penicillin group of antibiotics for 2–3 months and followed up for years to detect any recurrence.

Actinomyces causing chronic tonsillitis: a retrospective study

<p class="abstract"><strong>Background:</strong> Actinomyces is often overlooked and hence reported as rare infection of palatine tonsils. It can often lead to chronic tonsillitis and can masquerade as oropharyngeal malignancy. Objectives were to estimate the proportion of actinomyces causing chronic tonsillitis using histopathological evidence and to describe the histopathology of tonsillectomy specimens.</p><p class="abstract"><strong>Methods:</strong> Total 33 patients had undergone tonsillectomy in the study period of June 2018 to September 2020. Tonsil biopsy specimens stained with haematoxylin-Eosin stain and gram Stain were evaluated by light microscopy examination for the presence of actinomyces. </p><p class="abstract"><strong>Results:</strong> Total 4 Patients (8 tonsillectomy specimens) had evidence of actinomycosis on histopathological examination constituting 12.12 % of the total specimens examined, the mean age was 17 years (ranging from 5 to 42 years). One of the specimens had unilateral tonsillar cyst which revealed colonies of actinomyces.</p><p class="abstract"><strong>Conclusions:</strong> Actinomycosis of tonsil is a common condition which is usually missed as routine histopathological examination of excised tonsils is not done. Hence, we recommend routine histopathological examination of all tonsillectomy specimens irrespective of age.</p>

Histopathological Reporting of Actinomyces Colonies in Tonsils-Utility or Futility? A Retrospective Study

Introduction: Actinomyces colonies in tonsillectomy specimens are often ignored as commensals and histopathology reports do not carry any information about them. But evidence suggests that under favourable conditions these may become invasive and pathogenic, serving as precursors to later systemic disease. Early identification of mucosal breach by these bacteria may have a role in the clinical management and future prognosis. Aim: To determine the frequency of occurrence of Actinomyces colonies in tonsillectomy specimens and study the various associated histological alterations which may provide a clue to their pathogenicity. Materials and Methods: This was a retrospective study on 140 tonsillectomy specimens, from 70 patients who had undergone elective, bilateral tonsillar surgery. Tonsils were examined for Actinomyces colonies and histological alterations as per two different grading criteria. Different clinicopathological features were associated, those with and without Actinomyces colonies using appropriate statistical tools (t-test, Chi-square and Fisher’s exact test; Statistical Package for the Social Sciences {SPSS} version 23.0). Results: A total of 140 tonsillar tissue specimens were analysed from 70 patients and divided into two groups Group 1 (with actinomycosis) and Group 2 (without actinomycosis) with a mean age of 13.6±6.63 years and 11.8±7.19 years, respectively. The frequency of Actinomyces colonies was found to be 40% (28 of 70 patients) with bilateral presence in 28.5% (8 of 28 patients). Tissue reaction was present in 36.11% (13/36 tonsillar specimens) of the tonsillectomy specimens harbouring Actinomyces. Deeply situated colonies elicited tissue reaction more frequently (11/19 tonsillar specimens; 57.89%) compared to superficial ones (2/17 tonsillar specimens; 11.76%). Tonsillar cryptitis was the most statistically significant histopathological finding associated with the presence of Actinomyces colonies (p=0.029). Conclusion: Tonsillar cryptitis was found to be a consistent histological finding in tonsillar actinomycosis. The frequent acute inflammatory responses generated by deeply located Actinomyces colonies refutes their role as mere commensals. It is suggested that tonsil histopathology reports should mention the presence/ location/ tissue reaction surrounding Actinomyces colonies to differentiate mere colonisation from invasion. This could have profound clinical implications in terms of necessity of antibiotic use for prophylaxis/ and or treatment.

S2802 Abdominal Actinomycosis Mimicking Malignancy

INTRODUCTION: The abdominal subtype of actinomycosis is extremely rare; however, when present can mimic intraabdominal malignancies. We present an 88-year-old woman who presented with abdominal pain. Computed Tomography (CT) imaging showed multiple intra-abdominal soft tissue masses in the greater omentum, anterior abdominal wall, and small bowel mesentery suspicious for intraabdominal malignancy. She underwent CT guided biopsy showed filamentous gram-positive bacteria concerning for actinomycetes but no malignant process. CASE DESCRIPTION/METHODS: An 88-year-old woman presented with abdominal pain, fatigue, and 15 lb weight loss over the past month. On admission, she was afebrile. Physical examination revealed mild tenderness over the left lower abdominal quadrant. Initial labs revealed hemoglobin of 8.5 g/dl, WBC of 26,500/mm3. CT of the abdomen identified multiple intra-abdominal masses in the greater omentum, anterior abdominal wall, and small bowel mesentery, with contained perforation of sigmoid diverticulitis. Due to the localized nature of the perforation, the patient was initially treated with antibiotics. However, given worsening symptoms and leukocytosis, the patient underwent CT-guided percutaneous aspiration of right and left omental mass. Histopathological examination showed no evidence of malignancy but an infection/inflammatory process. Tissue gram stain revealed filamentous organisms in the area suggestive for actinomyces colonies on H and E stain. The acid-fast stain was negative. Based on these findings, a diagnosis of abdominal actinomycosis was rendered. The patient was treated with IV ampicillin/sulbactam for 4 weeks followed by oral amoxicillin for 16 more weeks. On follow up, CT imaging showed significant interval improvement of the omental and anterior abdominal wall masses. DISCUSSION: The case reported by us of abdominal actinomycosis aims to highlight the malignancy- mimicking clinical and imaging features of this disease with the clinical symptoms of weight loss, fatigue, chronic lower abdominal pain, and the imaging findings of an intraabdominal mass(es), The diagnosis may be confounded by abdominal malignancy. A biopsy can help ascertain the diagnosis and further guide the management, as in our case. Actinomycosis can be treated with long term antibiotics and surgical debridement of the infected tissue. The prognosis is usually excellent in healthy patients, prompting the physicians to keep abdominal actinomycosis in the differential diagnoses of suspected abdominal malignancy.Figure 1.: CT scan with contrast showing 4.3 cm × 2.4 cm Well defined structure of the abdomen that shows peripheral enhancement and low attenuation centrally. Finding suspicious of Fluid collection.

Actinomyces and MRONJ: A retrospective study and a literature review

The AAOMS in 2014 changed from BRONJ to the term Medication-Related Osteonecrosis of the Jaw (MRONJ), because of the growing number of osteonecrosis cases associated with other antiresorptive and antiangiogenic therapies. Even if the drugs involved are different, the histopathological findings are the same. Colonies of Actinomyces are encountered in most cases. The aim of the present study is to report on Actinomyces prevalence among the cases of MRONJ, taking into consideration also antiresorptive and antiangiogenic therapies in the literature and in our sample between 2005 and 2020.The review was performed using the database Medline the linkage between Actinomyces infection and MRONJ. The retrospective study was conducted on patients between with clinical and radiological manifestations of MRONJ May 2005 and February 2020.A total of 42 articles were found, 30 publications have been taken into consideration for the review. A total of 114 patients have been examined at the Padua Hospital. A total of 101 oncological patients presented the histological confirmation of MRONJ. 83 specimens revealed the presence of Actinomyces infection (82.18%).Actinomyces-associated lesions are frequent and present a wide spectrum of clinical manifestation.

Actinomyces abscess mimicking mandibular bone cyst

A radiolucent, well demarcated right mandibular bone lesion with a clinical presumptive diagnosis of solitary bone cyst was surgically excised in a 60 year old woman. The histopathologic examination revealed Actinomyces colonies surrounded by chronic granulation tissue. This presentation is unique due to its completely encapsulated abscess formation rather than the more common fistula formation seen in Actinomyces lesions.

Review of 1078 tonsillectomy: Retrospective cohort study

Aim: Tonsillectomy is one of the most frequently performed otolaryngologic surgical procedures. We represented our 5 years of experience in tonsillectomy and intended to compare our results with the current literature. We aimed to discuss our tonsillectomy outcomes, mainly giving emphasis on our post tonsillectomy infections and their possible relation with tonsillar pillar suturation, local anesthesia infiltration, comorbidities and presence of Actinomyces colonies in tonsil spesimens.Methods: This study was carried out retrospectively, in 1078 patients who underwent tonsillectomy operation in between December 2011 and December 2016. The demographic data of the patients, indications for tonsillectomy, suturation if applied, local anesthesia infiltration and its timing, histopathologic findings, co-morbid diseases, postoperative complications and rehospitalizations were recorded. The association of suturation, infiltration of local anesthesia and it’s timing (pre-incisional, post-dissectional), the histopathologic presentation of Actinomyces bacteria in tonsillar spesimens and the presence of accompanying systemic disorders with post- tonsillectomy infections were statistically analysed.Results: Postoperative infection was seen in 5 (0.5%) patients. Among the suturation group, only 1 (0.5%) patient had infection (p=1). In the infection group 4 (80%) patients had post dissectional local anesthesia infiltration (p=0.574). None of the patients treated with preincisional local anesthesia infiltration, had postoperative infection (p=0.574). In 3 (0.3%) patients, Actinomyces was determined. None of these cases had post-tonsillectomy infections. 142 (13.2%) patients had various co-morbidities associated. Among them, 1 (0.7%) patient had post-operative infection (p=0.507). Conclusion: According to our results, there is no statistically significant association between suturation of tonsillar pillars, local anesthesia infiltration, comorbidities and presence of Actinomyces and post tonsillectomy infections.

Actinomyces abscess mimicking mandibular bone cyst

A radiolucent well demarcated right mandibular bone lesion with a clinical presumptive diagnosis of solitary bone cyst was surgically excised in a year old woman The histopathologic examination revealed Actinomyces colonies surrounded by chronic granulation tissue This presentation is unique due to its completely encapsulated abscess formation rather than the more common fistula formation seen in Actinomyces lesions

Actinomycosis is not Frequent in the Periapex But is a Persistent Lesion.

Periapical actinomycosis caused by a gram-positive anaerobic pathogen characterizes a typical extra-radicular infection. This study determined the frequency and correlated the content of bacteria colonies with the of periapical actinomycosis size. The study comprised a total of 218 periapical lesions (PL) (cysts, granulomas or abscess). The specimens embedded in paraffin were sliced into 4-µm sections and stained with hematoxylin-eosin, Gram, Periodic Acid-Schiff (PAS) and Grocott's stain. The presence of bacterial colonies composed of filamentous structures labeled with the histochemical stains were described as Actinomyces, and for each case, the bacterial colonies were counted and measured. The correlation between the number and size of bacterial colonies and the size of PL was tested using Pearson's adjusted correlation coefficient. From 218 PL, bacterial colonies were identified in 64 biopsies. Seven cases (0.3%) fulfill the criteria for diagnosis of periapical actinomycosis. All of cases were therapy-resistant and did not showed periapical repair after 12 months of follow-up. Periapical surgery or dental extraction was performed. The correlation test indicated no correlation between the number of bacterial colonies and the lesion size (p=0.752, r=-0.148). However, a larger bacterial colony size generally resulted in a larger periapical lesion (P=0.000, r=0.657). The frequency of periapical actinomycosis was low, and this lesion should be included in the differential diagnosis of PL. The size of the Actinomyces colonies seemed to contribute to increase the size of the periapical lesion.

Perforated Diverticulosis Complicated with Actinomycosis and Presented as Pelvic Malignancy

A 48-year-old nonsmoker female with no significant past medical history is admitted to the hospital with lower abdominal pain, fatigue, yellow vaginal discharge and unintentionally weight loss. On physical examination there was a palpable mass extending from supra-pubic to supra-umbilical area and significant foul-smelling vaginal discharge. Computerized tomography of Pelvis revealed a mass like structure but biopsy showed acute inflammatory process with smooth muscle proliferation and fibro-adipose tissue infiltrated with histiocytes. Pathology revealed colonies of Actinomyces.

Bisphosphonate related osteonecrosis of the jaws: clinico-pathological investigation and histomorphometric analysis

Clinico-pathological evaluation of bisphosphonate (BP)-related osteonecrosis of jaws, comparison between oral (PO) and intravenous (IV) BPs and histomorphometric analysis of associated actinomyces. Retrospective clinical and histomorphometric analysis. Data on background, clinical, treatment and follow-up were analyzed. Actinomyces colonies were identified by typical filamentous colony morphology, Gram, and PAS stains. Colony density and relative colony surface area were measured. Fifty-two patients were included, 37 (71.2%) IV, 15 (28.8%) PO BPs. with a mean duration of 2.33 and, 4.33 years respectively. One hundred percent of cases exhibited actinomyces colonization. The relative colony surface area was significantly higher in PO treatment (P = .024), with no differences in density, healing time or antibiotic treatment periods. High frequency of diabetes mellitus (60% PO cases) and corticosteroid treatment (25% of cases) were recorded. Infection with actinomyces is a common denominator in BP-related osteonecrosis of the jaws (BRONJ), regardless of administration route. Diabetes and corticosteroid treatment seem to be important contributing factors for BRONJ.

Cutaneous Fistula Due to Pulmonary Actinomycosis in a Mapuche Girl

Actinomycosis is a chronic granulomatous disease caused by Gram-positive anaerobic bacteria of the genus Actinomyces. Pulmonary actinomycosis is a rare infection in children, and its extension into the chest wall is infrequently reported. We report a case of pulmonary actinomycosis in a 14-year-old girl of Mapuche descent who presented with chronic respiratory symptoms and multiple discharging skin sinuses on her right lower chest wall. The diagnosis was made by skin biopsy, which showed sulfur granules with actinomyces colonies. She was successfully treated with intravenous ceftriaxone and penicillin G for 6 weeks, followed by oral amoxicillin for 6 months.

Osteopathology associated with bone resorption inhibitors – which role does Actinomyces play? A presentation of 51 cases with systematic review of the literature

Bone resorption inhibitor-related osteopathology of the jaw (BRIOJ) is a severe complication in patients treated with bisphosphonates or denosumab. However, the precise pathogenesis of BRIOJ is not yet fully understood. Recent studies discovered the presence of Actinomyces colonies in biopsy material from BRIOJ patients. The aim of this study was to analyze current knowledge concerning the impact of Actinomyces on the pathogenesis of this condition and to present data from our own patients. Data from 51 patients with histopathological diagnoses of BRIOJ were retrospectively analyzed. In addition, a systematic literature search for studies describing the presence of Actinomyces was performed. Actinomyces was present in 86% of our cases and 63.3% of 371 cases presented in the literature. All of our patients and 85% of patients described in the literature had a clearly defined local focus in association with osteopathology. A clear picture of whether Actinomyces colonizes the previously necrotic bone or contributes to inflammation causing subsequent bone necrosis is lacking in the literature. The pathogenesis of BRIOJ remains unknown; however, there seems to be a role for Actinomyces, and possibly other pathogens, in the development of osteopathology of the jaws, which is not exclusive to bisphosphonate therapy. This study supports the hypothesis that an infectious component is of utmost importance for the pathogenesis of BRIOJ.

Carotid artery rupture and cervicofacial actinomycosis

Cervicofacial actinomycosis is an uncommon, progressive infection caused by bacilli of the Actinomyces genus. Actinomyces are common commensal saprophytes in the oral cavity which may have medical importance as facultative pathogens. Subsequent to local injuries to the oral mucosa, they may penetrate the deep tissues and be responsible for suppurative or granulomatous infections. We herein report a case of a 65-year-old man who underwent surgery followed by chemotherapy and radiotherapy for a tonsillar carcinoma. An ulcerous lesion in the base of the tongue developed and spread to the carotid artery wall. The man died of a massive hemorrhage due to left carotid artery rupture. Postmortem computed tomography angiography performed prior to autopsy allowed the precise localization of the source of bleeding to be detected. Postmortem biochemical investigations confirmed the presence of inflammation associated with local bacterial infection. Histological investigations revealed the rupture of the left carotid artery surrounded by numerous colonies of Actinomyces. Acute and chronic inflammation with tissue necrosis as well as post-actinic, fibrotic changes were also found in the tissues surrounding the ruptured artery wall.

Pulmonary Actinomycosis—A Case Report

Pulmonary actinomycosis is a rare disease caused by Actinomyces sp. Its symptoms and radiological findings are not characteristic, so the diagnosis might be difficult to establish. We report a case of a 59 year old male, who developed bronchopulmonary Actinomycosis due to poor dental hygiene. The infectious process affected lung parenchyma and infiltrated chest wall causing multifocal sternal osteolisis and multiple cutaneous fistulas. The radiological findings sugested neoplasmatical process. The diagnosis was based on histopatological findings of fistular scrapes. The material contained Actinomyces colonies. Afler 6 months of antibiotic therapy the patient's state improved and the cutaneous fistulas healed. Radiological finding revealed partial resolution of the lung infiltration.

Solitary renal actinomycosis.

A 53-year-old man, who was a recurrent stone former and diabetic, presented with left flank pain, pyuria, and fever. He had undergone multiple interventions for removal of the left kidney stones and retained ureteral double-J stent. All blood and urine investigations were unremarkable and negative for fungus and tuberculosis. Computed tomography scan revealed an edematous left kidney with poorly enhancing upper pole having dilated calyces with hyperdense contents suggestive of abscess (Figure 1). Ultrasonography-guided aspiration of left renal abscess grew Pseudomona Aeruginosa. Thereafter, patient underwent left laparoscopic nephrectomy. On gross examination, yellow sulfur granules in the dilated upper pole calyceal system were seen (Figure 2). Microscopic examination of the sulfur granules demonstrated homogenous eosinophilic hyaline material coating actinomyces colonies surrounded by a dense lymphoplasmacytic infiltrate (Splendore-Hoeppli phenomenon) with concomitant pyelonephritis (Figure 3). The patient was discharged on long-term doxycycline as he was allergic to penicillin. Solitary renal actinomycosis can present as pyelonephritis, renal/perinephric abscess, or renal mass. (1) Multiple interventions, recurrent urinary tract infection, retained double-J stent, uncontrolled diabetes mellitus, and untreated dental caries are predisposing factors for this disease. With development of effective antibiotics, the challenge now lies in the clinician’s ability to make the correct diagnosis, thus, ensuring timely recognition and renal salvage if possible. (2)

The clinical spectrum of Actinomyces-associated lesions of the oral mucosa and jawbones: correlations with histomorphometric analysis

To characterize the clinical manifestations of Actinomyces-associated lesions of the oral mucosa and jawbones, and to correlate the clinical course and treatment requirements with the findings of histomorphometric analysis. The study was a 10-year retrospective analysis of archived cases with microscopic identification of Actinomyces infection. Actinomyces colonies were identified, using hematoxylin-eosin, Gram, and periodic acid-Schiff stains, exhibiting filamentous morphology with color variation between center and periphery. Only colonies with adjacent tissue reaction (inflammation, fibrosis) were analyzed. Actinomyces density (AD) was calculated by dividing total number of colonies by tissue surface, Actinomyces relative surface (ARS) was calculated by dividing total bacterial surface by tissue surface. The study included 106 cases (48 male, 58 female; aged 13-84 years, mean 50.5 years). Cases presented a wide clinical spectrum, involving jawbone and/or oral soft tissues. Cases included osteomyelitis associated with bisphosphonates, osteoradionecrosis, osteomyelitis unrelated to radiation or bisphosphonates, periapical lesions, odontogenic cysts, periimplantitis, and lesion mimicking periodontal disease. The AD correlated with median length of antibiotic treatment (R = 0.284; P = .028). Because we were able to identify 106 such cases, the results indicate that Actinomyces-associated lesions may not be as rare as would be expected from the relatively low number of cases in the literature. Actinomyces-associated lesions presented in a wide spectrum of clinical settings and a variety of contributing factors. Quantitative analysis of the number of bacterial colonies (representing bacterial load) could help in evaluating the aggressive potential of the lesion and help in treatment planning.

Bronchoscopic View of a Tuberculosis Cavity With Actinomyces

Coexistence of pulmonary actinomycosis with tuberculosis has rarely been reported. The presence of Actinomyces in sputum and bronchoalveolar lavage is inadequate for diagnosis, as it may represent mere colonization. Traditionally, excisional biopsy is considered to be the gold standard for histologic diagnosis. There are multiple case reports in which the diagnosis of pulmonary actinomycosis was based on bronchial biopsy and Wang needle aspiration. We describe an incidental finding of a bronchial communication with passage of a flexible bronchoscope into the tuberculosis cavity. The images reveal a 5-cm cavity with a whitish, stone-like structure noticed to move back and forth with respiration. Colonies of Actinomyces were seen on transbronchial brushing cytology. Bronchoalveolar lavage cultures were negative. To our knowledge such a detailed pictorial description of a tuberculosis cavity with Actinomyces has not been reported in the past.