Genus Actinomyces Research Articles

Actinomycose pulmonaire disséminée avec atteinte hépatique : une forme trompeuse mimant un tableau polymétastatique

Thoracic actinomycosis, caused by bacteria of the Actinomyces genus, is a rare infection, with poor prognosis if untreated, whose clinical and radiological picture is misleading, which can simulate a tumoral or tuberculous disease. This is a case of generalised pseudotumoral pulmonary actinomycosis in a non-smoking, non-drinking 48-year-old man, who for one month has been presenting a cough with haemoptoic sputum, dyspnoea associated with fever and a deterioration in general condition. The clinical examination discovered weight loss, diffuse crackling rales and multiple dental caries. Biologically, he presented an inflammatory syndrome. The radiological imaging and lung and liver CT-scans discovered a peripheral lung mass right side associated with multiple nodular cannon-ball opacities, multiple liver lesions of metastatic appearance. The bacteriological examination of the bronchoalveolar lavage fluid (Gram stain and culture) and the transparietal biopsy of the lung mass confirmed the presence of Actinomyces. Progress under treatment with 10 million international units of parenteral penicillin G daily over a period of six weeks substituted by three grams of amoxicillin/clavulanic acid daily over a period of 12 months and following an oral preparatory procedure was favourable. The thoraco-abdominal scan carried out three months after the treatment showed that the lesions had completely disappeared. Our case illustrates the diagnostic difficulty of actinomycosis particularly faced with a picture of multiple lung and liver metastasis. Hence, the importance of a histological and bacteriological examination of samples. The prognosis of this complaint is generally good following well-managed, prolonged treatment; and the prognosis peculiar to disseminated forms is less certain.

Mandibular Actinomyces osteomyelitis complicating florid cemento-osseous dysplasia: case report

BackgroundApart from neoplastic processes, chronic disfiguring and destructive diseases of the mandible are uncommon.Case PresentationWe report, perhaps for the first time, the simultaneous occurrence of two such conditions in one patient, in a case that emphasizes the importance of bone biopsy in establishing the correct diagnosis. Florid cemento-osseous dysplasia (FCOD) is a chronic, disfiguring condition of the maxillofacial region. This relatively benign disease is primarily observed in middle-aged women of African ancestry. Cervicofacial actinomycosis is an uncommon and progressive infection caused by bacilli of the Actinomyces genus that typically involves intraoral soft tissues but may also involve bone. The accurate diagnosis of actinomycosis is critical for successful treatment. A diagnosis of osteomyelitis caused by Actinomyces bacteria was diagnosed by bone biopsy in a 53 year-old African-American woman with a longstanding history of FCOD after she presented with a new draining ulcer overlying the mandible.ConclusionsClinicians should be aware of the possibility of actinomycosis arising in the setting of FCOD, and the importance of bone biopsy and cultures in arriving at a definitive and timely diagnosis.

Pulmonary Actinomycosis as the Masquerader of Pulmonary Tuberculosis in a Young Male With Achalasia Cardia

Pulmonary infections range from acute pneumonia due to various bacteria and viruses to chronic infections due to mycobacterium tuberculosis and various fungi. Anaerobic gram-positive, nonspore-forming bacteria of the genus Actinomyces that affects the oropharynx, digestive tract, and genitalia cause the infection known as actinomycosis. Thoracic actinomycosis may affect the respiratory tract and the pleura, even extending to the chest wall. Pulmonary actinomycosis occurs in immunocompetent persons during the fourth and fifth decades of life, with prevalence in men and is generally due to Actinomyces israelii or A. meyeri. It is frequently misdiagnosed as primary or metastatic lung cancer or tuberculosis. The accepted predisposing factors for bronchopulmonary actinomycosis are poor dental hygiene, alcoholism and various chronic debilitating diseases, hiatus hernia, and gastroesophageal reflux. We are presenting an interesting case of pulmonary actinomycosis presenting with hemoptysis, associated with achalasia cardia and treated as tuberculosis.

Primary cutaneous actinomycosis caused by Actinomyces bovis in a patient with common variable immunodeficiency

Actinomycosis is a chronic, suppurative granulomatous disease caused by the genus Actinomyces. This report is an interesting case of primary cutaneous actinomycosis (PCA) in a patient with common variable immunodeficiency (CVI) affecting the fingernails. The patient was successfully treated with penicillin G, cefazolin and metronidazole as well as surgical debridement of the infected tissues. In a 4-year follow-up period, no recurrence was observed. Primary cutaneous actinomycosis is a rare disease and the diagnosis needs a high index of clinical suspicion with attention to the history of skin implantation of the organism.

Microbiota associated with chronic osteomyelitis of the jaws

Chronic osteomyelitis of maxilla and mandible is rare in industrialized countries and its occurrence in developing countries is associated with trauma and surgery, and its microbial etiology has not been studied thoroughly. The aim of this investigation was to evaluate the microbiota associated with osteomyelitis of mandible or maxilla from some Brazilian patients. After clinical and radiographic evaluation, samples of bone sequestra, purulent secretion, and biopsies of granulomatous tissues from twenty-two patients with chronic osteomyelitis of mandible and maxilla were cultivated and submitted for pathogen detection by using a PCR method. Each patient harbored a single lesion. Bacterial isolation was performed on fastidious anaerobe agar supplemented with hemin, menadione and horse blood for anaerobes; and on tryptic soy agar supplemented with yeast extract and horse blood for facultative bacteria and aerobes. Plates were incubated in anaerobiosis and aerobiosis, at 37(o)C for 14 and 3 days, respectively. Bacteria were cultivated from twelve patient samples; and genera Actinomyces, Fusobacterium, Parvimonas, and Staphylococcus were the most frequent. By PCR, bacterial DNA was detected from sixteen patient samples. The results suggest that cases of chronic osteomyelitis of the jaws are usually mixed anaerobic infections, reinforcing the concept that osteomyelitis of the jaws are mainly related to microorganisms from the oral environment, and periapical and periodontal infections may act as predisposing factors.

Management of Patients with Huge Pelvic Actinomycosis Complicated with Hydronephrosis: A Case Report

Actinomycosis is an uncommon, chronic, granulomatous disease caused by several species of the genus Actinomyces, a Gram-positive, filamentous bacterium that normally colonizes mucosal areas. Actinomycosis can be mistaken for malignant tumors, and in most cases the diagnosis is delayed or missed entirely until surgery. Actinomycosis in the abdomen or pelvis mostly results from prolonged use of an intrauterine device. We report the case of a 40-year-old female who presented with decreased urine production, poor appetite, marked loss of body weight and intermittent lower abdominal pain for 3 months. Abdominal computed tomography indicated a large infiltrative pelvic mass that was complicated by bilateral hydronephrosis, bladder compression and small bowel adhesions. Despite the elevated levels of cancer antigen 125, we suspected pelvic actinomycosis because of a 15-year history of an intrauterine device. The diagnosis was confirmed by histopathological examination of soft tissue obtained from a laparotomy biopsy. We successfully treated the patient with prolonged antibiotics instead of surgical eradication. Abdominal computed tomography obtained 1 year later showed almost complete resolution of the pelvic inflammatory mass.

Actinomyces timonensis sp. nov., isolated from a human clinical osteo-articular sample

Gram-positive, non-spore-forming rods were isolated from a human osteo-articular sample (strain 7400942(T)). Based on cellular morphology and the results of biochemical analysis, this strain was tentatively identified as a novel species of the genus Actinomyces. Phylogenetic analysis based on 16S rRNA gene sequence comparisons showed that the bacterium was closely related to the type strain of Actinomyces denticolens (96.9 % 16S rRNA gene sequence similarity). A comparison of biochemical traits showed that strain 7400942(T) was distinct from A. denticolens in a number of characteristics, i.e. in contrast with A. denticolens, strain 7400942(T) was negative for nitrate reduction and for beta-galactosidase, alpha-glucosidase and alanine arylamidase activities, it was positive for acid production from N-acetylglucosamine, melezitose and glycogen, and it was negative for acid production from turanose. Matrix-assisted laser-desorption/ionization time-of-flight MS protein analysis confirmed that strain 7400942(T) represents a novel species, as scores obtained for its spectra were significant (>2.2) only with strain 7400942(T). On the basis of phenotypic data and phylogenetic inference, it is proposed that this strain should be designated Actinomyces timonensis sp. nov.; the type strain is strain 7400942(T) (=CSUR P35(T)=CCUG 55928(T)).

Mediastinitis Due to <i>Actinomyces Naeslundii</i>

A 48-year-old man with retrosternal chest pain and upper abdominal pain with propagation to the back, with clinical signs of nausea, dyspnea and dysphagia was referred to the Clinics of thoracic surgery. After esophagography, operative treatment was indicated. Left thoracotomy with mediastinothomy were performed. During the operation, a sample of pus was taken and sent for a microbiological examination at the Institute of Microbiology and Parasitology, Medical Faculty in Skopje. Standard microbiological procedures were used. The sample was cultured anaerobically on Schaedler agar and incubated for 48 hours at 37oC. Oval, smooth colonies were observed. Gram stained smear revealed short branching Gram-positive filaments suspected for genus Actinomyces . For a definitive diagnosis and differentiation of the Actinomyces species, an automated VITEK system was used. Two weeks after treatment by ceftriaxon, metronidazol and analgetics, all clinical signs improved and patient was released in good physical condition.

Microbiota associated with chronic osteomyelitis of the jaws

Chronic osteomyelitis of maxilla and mandible is rare in industrialized countries and its occurrence in developing countries is associated with trauma and surgery, and its microbial etiology has not been studied thoroughly. The aim of this investigation was to evaluate the microbiota associated with osteomyelitis of mandible or maxilla from some Brazilian patients. After clinical and radiographic evaluation, samples of bone sequestra, purulent secretion, and biopsies of granulomatous tissues from twenty-two patients with chronic osteomyelitis of mandible and maxilla were cultivated and submitted for pathogen detection by using a PCR method. Each patient harbored a single lesion. Bacterial isolation was performed on fastidious anaerobe agar supplemented with hemin, menadione and horse blood for anaerobes; and on tryptic soy agar supplemented with yeast extract and horse blood for facultative bacteria and aerobes. Plates were incubated in anaerobiosis and aerobiosis, at 37oC for 14 and 3 days, respectively. Bacteria were cultivated from twelve patient samples; and genera Actinomyces, Fusobacterium, Parvimonas, and Staphylococcus were the most frequent. By PCR, bacterial DNA was detected from sixteen patient samples. The results suggest that cases of chronic osteomyelitis of the jaws are usually mixed anaerobic infections, reinforcing the concept that osteomyelitis of the jaws are mainly related to microorganisms from the oral environment, and periapical and periodontal infections may act as predisposing factors.

A Case of Adrenal Actinomycosis that Mimicked a Huge Adrenal Tumor

The incidence of adrenal incidentalomas has increased because imaging studies are now being more frequently performed, including abdominal sonography, CT and MRI. Although there is only a consensus on the treatment of adrenal incidentalomas from the National Institute of Health (NIH) conference 2003, it is generally accepted that surgical resection is required if there's any possibility of malignancy or functionality of the adrenal tumor. Abdominopelvic actinomycosis is a rare chronic progressive suppurative disease that is caused by gram-positive bacteria of the genus actinomyces, which is part of the normal flora of the oral cavity and gastrointestinal tract, with low virulence. Herein, we report on a case of adrenal actinomycosis that imitated a huge adrenal tumor in a 39-year-old women, and the adrenal actinomycosis was confirmed histologically only after adrenalectomy. To the best of our knowledge, this is the first Korean case report on actinomycosis that occurred in the adrenal gland.

Primary Actinomycosis of the Foot: A Case Report and Literature Review

Actinomycosis is an indolent, slowly progressive, suppurative infection caused by gram-positive branching bacteria of the genus Actinomyces. The organism is a member of the oral and gastrointestinal microflora of humans. The disease actinomycosis most commonly occurs in 3 body regions: cervicofacial (55% of patients), abdominopelvic (20%), and pulmonothoracic (15%). Involvement of other parts of the body is uncommon and usually secondary to a lesion in one or the other of the above sites. Extremity disease can occur by secondary involvement through direct extension or hematogenous spread. However, primary actinomycosis of an extremity is very rare. A case of primary actinomycosis of the foot in a Hispanic male and a literature review with an emphasis on primary actinomycosis of the extremity are presented in this article.

Actinomyces massiliensis sp. nov., isolated from a patient blood culture

Gram-positive, non-spore-forming rods (strain 4401292(T)) were isolated from a human blood sample. Based on cellular morphology and the results of biochemical tests, this strain was tentatively identified as belonging to an undescribed species of the genus Actinomyces. Phylogenetic analysis based on 16S rRNA gene sequence comparison showed that the bacterium was related closely to Actinomyces gerencseriae (95.1 % 16S rRNA gene sequence similarity), Actinomyces israelii (95.2 %), Actinomyces oricola (95.2 %), Actinomyces ruminicola (93.3 %) and Actinomyces dentalis (91.4 %). The predominant fatty acids were C18 : 1omega9c and C16 : 0. On the basis of phenotypic data and phylogenetic inference, the novel species Actinomyces massiliensis sp. nov. is proposed; the type strain is 4401292(T) (=CSUR P18(T)=CCUG 53522(T)).

L’actinomycose pulmonaire fistulisée à la paroi thoracique

Actinomycosis is a suppurative infection caused by bacteria of the genus actinomyces. It is a rare cause of pulmonary infection and can be difficult to diagnose as its presentation may mimic cancer or tuberculosis. In the absence of treatment of pulmonary lesions fistulae can develop. We report a case of pulmonary actinomycosis complicated by a chest wall fistula that was managed by the thoracic surgery unit at Chu Ibn Sina de Rabat. A 45 year old man who was previously fit and well presented with a left sided chest wall swelling with cutaneous fistulae. Pulmonary auscultation revealed evidence of left apical consolidation. Otherwise clinical assessment was unremarkable. Plain chest radiology revealed left apical opacification. CT scanning revealed a left pulmonary mass and percutaneous biopsy confirmed the diagnosis of actinomycosis. The patient was started on treatment and experienced a clinical and radiological improvement sustained at one year's follow up. We review the clinical and radiological characteristics of this condition as well as diagnostic difficulties, histological findings, therapeutic options and its natural history.

Pulmonary actinomycosis in two chamois (Rupicapra rupicapra)

Actinomycosis is a widespread non-contagious infectious condition, occurring both in animals and humans, caused by bacteria of the Actinomyces genus. In this report, two cases of pulmonary actinomycosis occurring in two wild chamois from northern Italy are described. In both cases, evidence of lung pyogranulomatous lesions with intra-lesional sulphur granules composed of filamentous, acid fast negative bacteria that stain positive for gram and periodic acid Schiff (PAS) leads to the etiological confirmation of pulmonary actinomycosis.

Studies on the diversity of actinomycetes in the Palk Strait region of Bay of Bengal, India

Totally 192 actinomycetes colonies were isolated from 18 marine sediment samples of Palk Strait region of Bay of Bengal, India. Among them, 68 isolates were morphologically distinct on the basis of colour of spore mass, reverse side colour, aerial and substrate mycelia formation, production of diffusible pigment and sporophore morphology. Thirty-nine isolates were assigned to the genus Streptomyces, Actinopolyspora (10), Saccharopolyspora (7), Actinomadura (4), Nocardiopsis (3), Micromonospora (2), Actinomyces (1), Actinoplanes (1) and Microbispora (1). From these, 64 isolates with aerial mycelia, 65 isolates with substrate mycelia and 61 isolates had both aerial and substrate mycelia.

Sequence analyses of fimbriae subunit FimA proteins on Actinomyces naeslundii genospecies 1 and 2 and Actinomyces odontolyticus with variant carbohydrate binding specificities

BackgroundActinomyces naeslundii genospecies 1 and 2 express type-2 fimbriae (FimA subunit polymers) with variant Galβ binding specificities and Actinomyces odontolyticus a sialic acid specificity to colonize different oral surfaces. However, the fimbrial nature of the sialic acid binding property and sequence information about FimA proteins from multiple strains are lacking.ResultsHere we have sequenced fimA genes from strains of A.naeslundii genospecies 1 (n = 4) and genospecies 2 (n = 4), both of which harboured variant Galβ-dependent hemagglutination (HA) types, and from A.odontolyticus PK984 with a sialic acid-dependent HA pattern. Three unique subtypes of FimA proteins with 63.8–66.4% sequence identity were present in strains of A. naeslundii genospecies 1 and 2 and A. odontolyticus. The generally high FimA sequence identity (>97.2%) within a genospecies revealed species specific sequences or segments that coincided with binding specificity. All three FimA protein variants contained a signal peptide, pilin motif, E box, proline-rich segment and an LPXTG sorting motif among other conserved segments for secretion, assembly and sorting of fimbrial proteins. The highly conserved pilin, E box and LPXTG motifs are present in fimbriae proteins from other Gram-positive bacteria. Moreover, only strains of genospecies 1 were agglutinated with type-2 fimbriae antisera derived from A. naeslundii genospecies 1 strain 12104, emphasizing that the overall folding of FimA may generate different functionalities. Western blot analyses with FimA antisera revealed monomers and oligomers of FimA in whole cell protein extracts and a purified recombinant FimA preparation, indicating a sortase-independent oligomerization of FimA.ConclusionThe genus Actinomyces involves a diversity of unique FimA proteins with conserved pilin, E box and LPXTG motifs, depending on subspecies and associated binding specificity. In addition, a sortase independent oligomerization of FimA subunit proteins in solution was indicated.

Actinomycotic brain infection: registered diffusion, perfusion MR imaging and MR spectroscopy

Actinomycotic brain infection is caused by an organism of the Actinomyces genus. We report here one such case. The methods used included coregistered diffusion, perfusion and spectroscopic magnetic resonance (MR) imaging. Decreased apparent diffusion coefficient, markedly elevated fractional anisotropy (FA) and reduced cerebral blood flow were observed. MR spectroscopy demonstrated elevated amino acids, acetate and succinate. Elevated FA values may be due to the microstructure of this special brain infection.

Scalp actinomycosis mimicking soft tissue mass

Actinomycosis is a rare, subacute or chronic bacterial infection, characterized by localized swelling with suppuration, abscess formation, tissue fibrosis, and draining sinuses. It is caused by gram-positive, pleomorphic non-spore-forming, non-acid-fast anaerobic or microaerophilic bacilli of the genus Actinomyces. In humans, actinomyces are often normally found in the oral cavity, the gastrointestinal tract and the female genital tract. Infections of the oral and cervicofacial regions are the most commonly reported cases. We present a case of subcutaneous actinomycosis, localized at the upper segment of the posterior neck space, with scalp involvement.

Considerazioni su un caso di actinomicosi cervicale

Actinomycosis is a bacterial infection due to Gram positive bacteria of Actinomyces genus. Actinomyces israelii is the most common in human infection.The authors described a case occurred in a 43 aged woman with a clinical presentation of a right submandibular indurative mass.After surgery, histological examination showed a granulomatous tissue with many actinomycetes. Patient was submitted to treatment with i.v penicillin. On the 11th day antibiotic therapy was replaced with ceftriaxone and teicoplanina. Patient did not present intercurrence during this period and presented improvement of the lesion.Actinomycosis is an uncommon disease. Establishment of the definite diagnosis requires a high index of suspicion in all cases of relapsing cervical lesions. Penicillin is effective and it can be replaced by third-generation cephalosporins.

ADRENAL ACTINOMYCOSIS MIMICKING A LARGE TUMOR OF THE ADRENAL GLAND

Frequent use of imaging methods has led to an increased incidence of adrenal incidentalomas. Although there is no general consensus on their management, surgery is necessary in cases of hormonal overproduction or tumors greater than 4 to 6 cm. Actinomycosis is a rare chronic suppurative disease caused by gram-positive bacteria of the genus actinomyces that are saprophytes of the human oral mucosa with a low level of virulence. However, in recent years a number of cases have been reported in association with immunodeficiency, mainly AIDS. Adrenal actinomycosis has been described in 2 cases without histological documentation.1, 2 We report an unusual case of adrenal actinomycosis mimicking a large tumor of the left adrenal gland in association with unrecognized diabetes mellitus.