Aggregatibacter Actinomycemcomitans Pneumonia in Children

Shilo, Smadar; Kassis, Imad; Hakim, Fahed; Shachor-Meyouhas, Yael

doi:10.1097/inf.0000000000000493

Cited by 14 publications

(4 citation statements)

References 10 publications

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“…Aa infections may have different locations in children. There were described different pediatric cases with pulmonary involvement: 1 patients with pneumonia [ 8 ], 1 with empyema [ 14 ], 2 patients with pneumonia associated with chest wall mass [ 8 , 14 ], 6 cases of lung consolidation with chest wall mass and a bony involvement (especially lytic lesions of the ribs), associated in 3 cases with a pleural effusion and in 1 case with a mediastinal and pulmonary abscesses [ 9 , 14 – 17 ], 3 cases of pneumonia associated with empyema [ 8 , 10 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Aggregatibacter actinomycetemcomitans infection in a 15-year-old boy with pulmonary empyema: a case report and review of literature

et al. 2023

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Background Aggregatibacter actinomycetemcomitans (Aa), previously known as Actinobacillus actinomycetemcomitans, is a slow-growing Gram-negative coccobacillus, member of the HACEK group of bacteria colonizing oral flora. Besides causing infectious diseases in the oral cavity such as dental caries and periodontitis, it is responsible for severe extra-oral infections secondary to hematogenous spread or aspiration, such as endocarditis, soft tissue abscesses and osteomyelitis. The diagnosis depends on prolonged bacterial culture of biological material obtained through biopsy. Aa is susceptible to most antibiotics but complete eradication often requires a long term treatment. Case presentation We report the case of a 15-year-old previously healthy boy diagnosed with both pulmonary empyema and subphrenic chest wall abscess caused by Aa. He was admitted to our Pediatric Emergency department for evaluation of a right mass associated with marked asthenia and dry cough. After radiological findings etiological diagnosis was made by culture of fluid drainage of pleural empyema. He started empirical antibiotic therapy with intravenous piperacillin/tazobactam, whose sensibility was confirmed by the antibiogram, then, for occurrance of hepatopathy it was switched to ciprofloxacin: the patient almost completely recovered after 6-month therapy. Conclusions Extra-oral infections caused by Aa are extremely rare, especially in children, and not well described yet. To our knowledge, there is only another similar case described in literature. However, the case described in our manuscript represents the only one presenting with pulmonary empyema without involvement of lung parenchyma in children. We also conducted a brief review of published cases of Aa infection in the pediatric population. This case report reminds us the importance of an accurate inspection of the oral cavity during the examination of pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Aggregatibacter actinomycetemcomitans infection in a 15-year-old boy with pulmonary empyema: a case report and review of literature

et al. 2023

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“…in addition to the aforementioned periodontal pathogens, A. actinomycetemcomitans, as a periodontal pathogen highly associated with aggressive periodontitis, could also cause aspiration pneumonia or empyema associated with dental disease and oral mucosal injury (88). A literature search showed that 3 previously published cases of pneumonia caused by A. actinomycetemcomitans resembled malignant tumors (89)(90)(91). Patients with this type of pneumonia had similar symptoms and signs, including: i) cough, hemoptysis, weight loss and fever; ii) chest radiography revealing consolidation in the lung; iii) pathology revealing a chronic inflammation process, with presence of malignant cells with or without sulfur granules; iv) effectiveness of antibiotic treatment; v) potential co-infection with Actinomyces spp.…”

Section: Periodontal Pocket May Be a Potential Source Of Respiratory ...mentioning

confidence: 99%

“…; and vi) poor oral health (such as periodontitis and missing teeth). Pulmonary infection can be caused by A. actinomycetemcomitans by either inhalation of bacteria into the lungs due to poor oral hygiene or by bacteria entering the bloodstream from the broken inner wall of the mouth (hematogenous dissemination) (89)(90)(91). A. actinomycetemcomitans is an important pathogenic bacterium in aggressive periodontitis.…”

Section: Periodontal Pocket May Be a Potential Source Of Respiratory ...mentioning

confidence: 99%

Advances in the relationship between periodontopathogens and respiratory diseases (Review)

Zhang,

Wen,

Liu

et al. 2024

Mol Med Rep

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Periodontitis is a common chronic inflammatory and destructive disease in the mouth and is considered to be associated with systemic diseases. Accumulating evidence has suggested that periodontitis is a risk factor for pulmonary diseases such as pneumonia, chronic obstructive pulmonary disease (COPD), asthma, coronavirus disease 2019 (COVID-19) and lung cancer. The presence of common periodontal pathogens has been detected in samples from a variety of pulmonary diseases. Periodontal pathogens can be involved in lung diseases by promoting the adhesion and invasion of respiratory pathogens, regulating the apoptosis of respiratory epithelium and inducing overexpression of mucin and disrupting the balance of immune systemin respiratory epithelium cells. Additionally, measures to control plaque and maintain the health of periodontal tissue can decrease the incidence of respiratory adverse events. This evidence suggests a close association between periodontitis and pulmonary diseases. The present study aimed to review the clinical association between periodontitis and pneumonia, COPD, asthma, COVID-19 and lung cancer, and propose a possible mechanism and potential role of periodontal pathogens in linking periodontal disease and lung disease. This could provide a direction for further research on the association between periodontitis and lung disease and provide novel ideas for the clinical diagnosis and treatment management of these two diseases.

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“…Aggregatibacter actinomycetemcomitans is a gram‐negative facultative anaerobic bacterium that colonizes the oral cavity of humans and is associated with both chronic and juvenile forms of periodontal disease (Zambon et al., 1983). Moreover, A. actinomycetemcomitans is understood to be the source of multiple extra‐oral infections at a variety of distal sites via hematological spread from the oral cavity, including the heart, bones, lungs, and skin (Das et al., 1997; Liljestrand et al., 2018; Paturel et al., 2004; Rahamat‐Langendoen et al., 2011; Sharma et al., 2017; Shilo et al., 2015). These various organs share common and, at the same time, unique physiologic properties.…”

Section: Introductionmentioning

confidence: 99%

Regulation of adhesin synthesis in Aggregatibacter actinomycetemcomitans

Tristano

Danforth

Wargo

et al. 2023

Molecular Oral Microbiology

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Aggregatibacter actinomycetemcomitans is a gram‐negative bacterium associated with periodontal disease and a variety of disseminated extra‐oral infections. Tissue colonization is mediated by fimbriae and non‐fimbriae adhesins resulting in the formation of a sessile bacterial community or biofilm, which confers enhanced resistance to antibiotics and mechanical removal. The environmental changes experienced by A. actinomycetemcomitans during infection are detected and processed by undefined signaling pathways that alter gene expression. In this study, we have characterized the promoter region of the extracellular matrix protein adhesin A (EmaA), which is an important surface adhesin in biofilm biogenesis and disease initiation using a series of deletion constructs consisting of the emaA intergenic region and a promotor‐less lacZ sequence. Two regions of the promoter sequence were found to regulate gene transcription and in silico analysis indicated the presence of multiple transcriptional regulatory binding sequences. Analysis of four regulatory elements, CpxR, ArcA, OxyR, and DeoR, was undertaken in this study. Inactivation of arcA, the regulator moiety of the ArcAB two‐component signaling pathway involved in redox homeostasis, resulted in a decrease in EmaA synthesis and biofilm formation. Analysis of the promoter sequences of other adhesins identified binding sequences for the same regulatory proteins, which suggests that these proteins are involved in the coordinate regulation of adhesins required for colonization and pathogenesis.

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Aggregatibacter Actinomycemcomitans Pneumonia in Children

Cited by 14 publications

References 10 publications

Aggregatibacter actinomycetemcomitans infection in a 15-year-old boy with pulmonary empyema: a case report and review of literature

Aggregatibacter actinomycetemcomitans infection in a 15-year-old boy with pulmonary empyema: a case report and review of literature

Advances in the relationship between periodontopathogens and respiratory diseases (Review)

Regulation of adhesin synthesis in Aggregatibacter actinomycetemcomitans

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