Asymptomatic subcutaneous cervical mass due to <i>Actinomyces odontolyticus</i> infection in a pyriform sinus fistula

Yanagisawa, Ryu; Minami, Kisei; Kubota, Noriko; Iwade, Tamaki; Ogiso, Yoshifumi

doi:10.1111/ped.13321

Cited by 4 publications

(1 citation statement)

References 4 publications

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“…Empyema caused by A odontolyticus can cause subcutaneous abscesses and sinuses by penetrating the thoracic wall [ 4 , 10 ] and even respiratory failure in severe patients. [ 11 ] Ashley Gray reported a case of a child with endobronchial A odontolyticus infection presenting with cystic bronchiectasis on thoracic CT. [ 12 ] The key to successful treatment of empyema is the combination of appropriate anti-infection drug therapy and pus drainage. Medical thoracoscopy can reduce pleural separation and adhesion of empyema and help accurately insert the thoracic drainage tube.…”

Section: Discussionmentioning

confidence: 99%

Empyema caused by Actinomyces odontolyticus: A case report

Wang,

Xiao,

Wang

2024

Medicine

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Rationale: Actinomyces odontolyticus causes a rare, chronic granulomatous infection that is frequently associated with immunocompromised states. A odontolyticus can cause infection in multiple organs, but empyema is rare. Patient concerns: We report a case of empyema caused by A odontolyticus. The patient was a 64-year-old man. He was admitted to the hospital with a 5-day history of fever and dyspnea. He had caries and sequelae of cerebral apoplexy. Diagnoses: Metagenome next generation sequencing of pleural effusion was positive for A odontolyticus. Pathogen was identified by biphasic culture of pleural effusion fluid. Interventions: According to the drug sensitivity test, linezolid 0.6 g twice daily and clindamycin 0.6 g 3 times a day were administered intravenously. Thoracic drainage was initially performed, but the drainage was not sufficient. Medical thoracoscopy was performed to fully drain the pleural effusion. Outcomes: After anti-infection and medical thoracoscopic therapy, the symptoms of this patient improved. Lessons: Microbial metagenome sequencing can find pathogens that are difficult to culture by traditional methods. Adequate drainage was the key to the treatment of empyema. Medical thoracoscopy was recommended to remove the pleural effusion and spoilage when thoracic drainage is difficult. The common clinical features of A odontolyticus include a mass or swelling, abdominal disease, dental disease, and subcutaneous abscesses. Microbial metagenome sequencing can find pathogens that are difficult to culture by traditional methods. Adequate drainage was the key to the treatment of empyema. Medical thoracoscopy was recommended to remove the pleural effusion and spoilage when thoracic drainage is difficult.

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Section: Discussionmentioning

confidence: 99%

Empyema caused by Actinomyces odontolyticus: A case report

Wang,

Xiao,

Wang

2024

Medicine

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A case of pediatric cervicofacial actinomyces masquerading as malignancy: Case report and review of the literature

Savoca

Mehra

Waldman

2019

International Journal of Pediatric Otorhinolaryngology

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Cervicofacial Actinomycosis in the Pediatric Population: Presentation and Management

Gandhi

Woerd

Graham

et al. 2021

Ann Otol Rhinol Laryngol

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Background: Infection caused by Actinomyces species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis. Methods: Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region. Results: Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and prolonged antibiotic therapy. Thirty-four pediatric cases of cervicofacial actinomycosis are reviewed, 2 presented herein, and 32 from the published literature. There was equal gender distribution and the median age was 7.5 years. The most common site for infection was the submandibular area. Four (12%) of cases arose in pre-existing congenital lesions. Most patients were treated with penicillin-based antibiotics for a median duration of 6 months following surgical excision or debridement. Conclusions: Actinomycosis is a rare infection of the cervicofacial region; secondary infections arising from congenital lesions of the head and neck are even more rare. A previously excised pre-auricular sinus and a sublingual dermoid cyst are not previously reported sites of infection. Actinomycosis should be suspected in chronically draining sinuses of the head and neck region and confirmed through anaerobic culture. Osteomyelitis is a potential complication and magnetic resonance (MR) imaging is warranted. Long-term antibiotic therapy with a penicillin-based antibiotic and surgical excision should be considered.

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Asymptomatic subcutaneous cervical mass due to Actinomyces odontolyticus infection in a pyriform sinus fistula

Cited by 4 publications

References 4 publications

Empyema caused by Actinomyces odontolyticus: A case report

Empyema caused by Actinomyces odontolyticus: A case report

A case of pediatric cervicofacial actinomyces masquerading as malignancy: Case report and review of the literature

Cervicofacial Actinomycosis in the Pediatric Population: Presentation and Management

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