A case series of actinomycosis from a single tertiary care center in Saudi Arabia

Abstract

Actinomycosis is an uncommon but curable chronic infection caused by Actinomyces spp. The cervicofacial region is the most susceptible to infection; however, other sites may also become infected. Data on the current prevalence of this rare disease in Riyadh, Saudi Arabia is lacking. We herein report a case series of four patients with actinomycosis from a single tertiary care center in Riyadh, Saudi Arabia.Three patients presented to us with slowly progressing actinomycosis and one patient developed an acute abdomen, secondary to viscus perforation. Two of the patients had cervicofacial disease, including hard palate actinomycosis. Tissue cultures were sent for three patients; however, tests for actinomycosis were negative. Subsequently, the diagnosis was made through histopathological examination. Therapy involved a combination of surgical resection and debridement and prolonged antimicrobial treatment tailored to each patient.The cases reported in this series highlight the difficulty in diagnosing actinomycosis. For most patients, the diagnosis was delayed or accidentally discovered on histopathological examination. We conclude that increased awareness among physicians is needed for early diagnosis and treatment of actinomycosis.

Acute Appendicitis Secondary to Actinomycosis Gastrointestinal Infection – A Case Report

“…[11,12] Hence, physicians should be considered at the end of their differential diagnosis list and follow the pathology results to prevent misdiagnosis. [10,13,14] Antibiotic therapy is the conventional treatment of actinomycosis. High-dose i.v penicillin G (18-24 million units/day) for 2-6 weeks, followed by penicillin V or amoxicillin orally for 6-12 months, is suggested for treatment and relapse prevention.…”

Cervicofacial actinomycosis: important considerations on a mimicking disease

“…That is because of the avascular fi brotic walls of the lesions (19,29,30), which maintains the anaerobic environment, stimulating the organisms' growth (11,31). Depending on disease severity, therapy may consist of high doses of penicillin G IV (10 to 20 million IU/day) for days or weeks, followed by oral penicillin V (2 to 4 g / day) for 3 to 12 months (13,17,(32)(33)(34).…”

Microvascular flap reconstruction of pharynx in patient with actinomycosis

“…Microbiological studies on tonsils after tonsillectomies have shown that actinomyces colonize tonsillar crypts in 6.7%‐35% of samples 1,3 …”

“…The disease is characterized by the formation of slightly painful pseudotumor of slow growth, which may progress into abscess and form fistulous tracts. Diseases associated with actinomycosis may also resemble malignancies, tuberculosis, and nocardiosis, often leading to misdiagnosis 2,3 …”