Aggregatibacter actinomycetemcomitans osteomyelitis in a 12 year old boy: case report emphasizing the importance of tissue culture, and review of literature

Sharma, Ketaki; Mudgil, Poonam; Whitehall, John; Gosbell, Iain B

doi:10.1186/s12941-017-0186-0

Cited by 15 publications

(5 citation statements)

References 24 publications

(15 reference statements)

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“…Besides, one case of osteomyelitis [ 13 ], one with septic arthritis [ 18 ], one with endocarditis after valvuloplasty [ 19 ] and a one case of a soft tissue mass over mandibular area [ 20 ] are reported.…”

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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“…Besides, one case of osteomyelitis [13], one with septic arthritis [18], one with endocarditis after valvuloplasty [19] and a one case of a soft tissue mass over mandibular area [20] are reported.…”

Section: Timeline Discussion and Conclusionmentioning

confidence: 99%

“…Until January 2021, 20 cases of Aa infection were reported in the literature (including in the search patients aged 0 to 18), 11 females and 8 males, the age of the patients ranged from 1.5 to 18 years: in some cases it was the only isolated pathogen (15/20 cases), in 5 cases it was associated with other bacteria including Actinomyces israelii, Bacteroides ureolyticus (B. corrodens), Eikenella corrodens and Haemophilus. aphrophiIus, capnocytophaga species [8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Section: Timeline Discussion and Conclusionmentioning

confidence: 99%

Aggregatibacter Actinomycetemcomitans Infection In A 15-Year-Old Boy With Pulmonary Empyema: A Case Report And Review Of Literature

Mesturino

Bitetti

Clemente

et al. 2023

Preprint

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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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“…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 actinomycetemcomitans osteomyelitis in a 12 year old boy: case report emphasizing the importance of tissue culture, and review of literature

Cited by 15 publications

References 24 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

Aggregatibacter Actinomycetemcomitans Infection In A 15-Year-Old Boy With Pulmonary Empyema: A Case Report And Review Of Literature

Regulation of adhesin synthesis in Aggregatibacter actinomycetemcomitans

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