Actinomycosis of the breast and lungs

Fred, Herbert L.; Aisenberg, Gabriel M; Dijk, Hendrik A. van

doi:10.1080/08998280.2018.1540251

Cited by 3 publications

(2 citation statements)

References 25 publications

(25 reference statements)

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“…[ 1 ] It is an often relapsing granulomatous infection that characteristically crosses tissue planes and forms abscesses and sinus tracts. [ 2 ] First described by Ammentrop in 1893, primary actinomycosis of the breast is very rare and most commonly caused by Actinomyces israelii which normally inhabits the mouth, colon, and vagina. [ 3 - 5 ]…”

Section: Review Of the Topicmentioning

confidence: 99%

Breast lump: “Keep me in your differentials”

2023

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Section: Review Of the Topicmentioning

confidence: 99%

Breast lump: “Keep me in your differentials”

2023

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“…Endemic mycoses, such as coccidioidomycosis, are known causes of miliary disease [31][32][33][34][35], as are other fungal infections [36][37][38][39]. Several bacterial infections, such as non-tuberculous mycobacteria [40], actinomycosis [41], and various other types of infection [42,43], can present with a miliary pattern, as can viral [44,45] and parasitic [46] infections.…”

Section: Introductionmentioning

confidence: 99%

Examining Miliary Disease Etiology in a Coccidioides-Endemic Center: A Retrospective Cohort Study

Scott,

Lim,

Randhawa

et al. 2023

JoF

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Background: A miliary pattern on chest imaging is often attributed to tuberculosis (TB) infection. However, a myriad of conditions can cause a miliary pattern, many of which are imminently life-threatening. Research Question: The primary aim of our study is to elucidate the potential causes of miliary chest imaging patterns to improve workup and empiric therapy selection. The secondary aims are to discern the predictors of miliary disease etiology and to determine whether appropriate empiric antimicrobial therapies were given. Study Design and Methods: In this retrospective cohort study, we searched a radiology database for patients with chest imaging studies described by the word “miliary”. Subjects were excluded if they were under 18 years of age and if there were insufficient objective data to support a miliary disease etiology. A radiologist independently reviewed all imaging studies, and studies that did not appear to have a true miliary pattern were excluded. The collected data include patient demographics, immunocompromising risk factors, conditions associated with miliary disease, β-D-glucan levels, serum eosinophil count, and empiric therapies received. Results: From our 41-patient cohort, 22 patients (53.7%) were clinically diagnosed with coccidioidomycosis, 8 (19.5%) with TB, 7 (17.1%) with metastatic solid cancer, 1 (2.4%) with lymphoma, 1 (2.4%) with other (Mycobacterium simiae), and 3 (7.3%) with unknown diseases (the sum equals 42 patients because one individual was diagnosed with both coccidioidomycosis and TB). All six patients with greater than 500 eosinophils/μL were diagnosed with coccidioidomycosis. Of the 22 patients diagnosed with coccidioidomycosis, 20 (90.91%) were empirically treated with an antifungal regimen. Of the eight patients with TB, six were empirically treated for TB. Interpretation: Based on our data from a Coccidioides-endemic region with close proximity to tuberculosis-endemic areas, the leading cause of miliary disease is coccidioidomycosis, although TB and cancer are also common etiologies. Serum eosinophilia and elevated β-D-glucan levels were strongly predictive of coccidioidomycosis in our patient cohort with a miliary chest imaging pattern.

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