Diagnosis and Management of Cervicofacial Actinomycosis: Lessons from Two Distinct Clinical Cases

Abstract

Members of the Actinomyces genus are non-spore-forming, anaerobic, and aerotolerant Gram-positive bacteria that are abundantly found in the oropharynx. They are the causative agents of actinomycosis, a slowly progressing (indolent) infection with non-specific symptoms in its initial phase, and a clinical course of extensive tissue destruction if left untreated. Actinomycoses are considered to be rare; however, reliable epidemiological data on their prevalence is lacking. Herein, we describe two representative and contrasting cases of cervicofacial actinomycosis, where the affected patients had distinctively different backgrounds and medical histories. Identification of the relevant isolates was carried out using matrix-assisted laser desorption/ionization mass spectrometry; antimicrobial susceptibility was performed using E-tests. Cervicofacial actinomycoses are the most frequent form of the disease; isolation and identification of these microorganisms from relevant clinical samples (with or without histological examination) is the gold standard for diagnosis. The therapy of these infections includes surgical debridement and antibiotic therapy, mainly with a penicillin-derivative or clindamycin.

It’s Not Easy Being Green: A Narrative Review on the Microbiology, Virulence and Therapeutic Prospects of Multidrug-Resistant Pseudomonas aeruginosa

“…Biofilm formation is a critical attribute of P. aeruginosa in being a successful nosocomial pathogen and it is also an important hallmark of chronic bacterial persistence. This may be observed in dental caries on the tooth surfaces [85,86], in skin and soft tissue infections [52], in infections of the middle ear [87], catheter-associated infections [19], pneumonia, and in the lungs of CF patients [88]. In the latter case, P. aeruginosa is able to survive and avoid clearance (withstanding the immune response and the subsequent administration of antimicrobials) in the respiratory and conductive zone of the lungs [89,90].…”

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

“…In a recent review, 26 individual Actinomyces species were listed, which were known to be implicated in human infections (see Table 1) [37], but it would be safe to assume that more than these 26 species may have had a role in clinically relevant infectious pathologies. The number of these reported species may be a reported estimation only, as clinical isolates were frequently misidentified before the introduction of current diagnostic technologies (e.g., DNA-DNA hybridization, polymerase chain reaction (PCR), matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and whole-genome/next-generation sequencing (WGS/NGS) [1,12,37,38]. According to the data of the literature a wide range of Actinomyces species has been reported with increasing frequency nowadays as causes of infection at various body sites [1,12,37].…”

“…before the introduction of current diagnostic technologies (e.g., DNA-DNA hybridization, polymerase chain reaction (PCR), matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and whole-genome/next-generation sequencing (WGS/NGS) [1,12,37,38]. According to the data of the literature a wide range of Actinomyces species has been reported with increasing frequency nowadays as causes of infection at various body sites [1,12,37].…”

Utility of Photodynamic Therapy in Dentistry: Current Concepts

“…Among the various pathologies of the oral cavity, bacterial, viral and fungal lesions present an important factor for patient presentation in dental practices [79][80][81]. Although the use of PDT in infectious diseases of the oral cavity may seem uncommon, there is increasing interest toward this treatment modality in this field [82].…”