Bacteremia and urogenital infection with Actinomyces urogenitalis following prolonged urinary retention

Abstract

A case of bacteremia with the fastidious bacteria Actinomyces urogenitalis following lengthy urinary retention is reported in a sixty‐year‐old man. In 2013, the first case of bacteremia due to A. urogenitalis was presented, secondary to a tubo‐ovarian abscess following transvaginal oocyte retrieval. To the best of our knowledge, this is the first male bacteremic episode involving A. urogenitalis related to a urinary tract focus. The patient had no prior urogenital medical history. Extensive susceptibility testing was done on isolates from urinary and blood cultures. The organism exhibited fluoroquinolone resistance but was susceptible to most other antibiotics used in the treatment of urinary infections. Due to its unusual growth requirements infections with A. urogenitalis are most likely an underdiagnosed entity.

The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era

“…The correct differential diagnosis of primary bladder actinomycosis is very important, because of it might be protect unnecessary surgical resection for suspected tumor [124]. In both males and females, A. turicensis has been reported from clinical samples of urethritis and cystitis, A. neuii has been associated with urinary tract infection, A. europaeus with cystitis or purulent urethritis and as its name implies, A. urogenitalis strains were found in clinical samples from urethra and urine [12,37,106,125]. In these clinical samples, there are often some other aerobic and facultative bacteria present and only slightly elevated levels of leukocytes are observed in urine during urinalysis [12,37,106,125].…”

“…In both males and females, A. turicensis has been reported from clinical samples of urethritis and cystitis, A. neuii has been associated with urinary tract infection, A. europaeus with cystitis or purulent urethritis and as its name implies, A. urogenitalis strains were found in clinical samples from urethra and urine [12,37,106,125]. In these clinical samples, there are often some other aerobic and facultative bacteria present and only slightly elevated levels of leukocytes are observed in urine during urinalysis [12,37,106,125]. In addition to Actinomyces spp., other fastidious Gram-positive taxa has been recognized recently as etiological agents of urogenital infections, namely, A. schaalii, Aerococcus urinae and the much less known Aerococcus sanguinicola [126,127].…”

“…The two Aerococcus species are well recognized etiological agents of urinary tract infection, both species have been associated with bacteremic/septicemic episodes, and in rare instances, A. urinae has also been identified as a causative agent of infective endocarditis [129]. Holmgaard et al [125] described a case of bacteremia and urogenital infection with A. urogenitalis following prolonged urinary retention in an otherwise healthy sixty-year-old man, who had no prior urogenital medical history. A. schaalii was first described as a causative agent of human infections in 1997 by Lawson et al [25], and since then, the uropathogenic role of the bacteria has been increasingly demonstrated, mainly causing UTIs in elderly individuals with underlying urological diseases [130].…”

UrinaryActinomycesinfection with a urachal remnant

“…Actinomyces infections are associated with long-term urinary retention and urachal remnants, both of which were present in our patient 2…”

The efficacy of anti-microbial agents against Actinomyces species isolated from patients with dental caries

“…usually entails prolonged courses of anti-microbials. Surgical intervention may also be necessary in advanced cases, depending on areas of infection (e.g., epidural infections, brain abscesses), in patients with large hemoptysis, or in cases where intensive abscesses and fistulous tracts are found [14]. Actinomyces spp.…”