Disseminated cutaneous Actinomyces bovis infection in an immunocompromised host: case report and review of the literature

Abstract

Background Actinomycosis is an uncommon endogenous bacterial infection caused by Actinomyces species, characterized by the development of abscesses, tissue fibrosis, and fistulisation. It remains a diagnostic challenge, due to its similarities with diverse aetiologies’ presentation, such as neoplasms, tuberculosis, or fungal infections. Actinomyces bovis is a microorganism rarely reported as a cause of human disease. Cutaneous involvement is sporadic. In this case, Actinomyces bovis was responsible for disseminated cutaneous disease in an immunosuppressed patient. Case presentation We report the case of a 69-year-old female with multiple skin masses, under immunosuppressive therapy due to ulcerative colitis. Imaging exams were compatible with multiple cutaneous abscesses in the cervicofacial region and limbs. Actinomyces bovis was isolated in culture after abscess drainage. Antimicrobial therapy with parenteral penicillin G and oral amoxicillin was administered for 6 months, with complete resolution of cutaneous lesions and no relapse of the infection. Conclusions Considering actinomycosis as a possible diagnosis in the presence of subacute/chronic recurrent mass-like cutaneous lesions, especially in the setting of immunosuppression, may reduce the burden associated with delayed diagnosis and incorrect treatment and provide better outcomes and improvement of patient’s quality of life.

Characterization of the gut microbiota in different immunological responses among PLWH

“…This suggests that a reduction of Parabacteroides may be one of the reasons for increased levels of in ammation in INRs vivo. Actinomycetes is Gram-positive bacteria and facultative pathogenic bacteria 41 . Actinomyces can enter the bloodstream through damaged tissues and cause systemic infections, including central nervous system, cardiovascular, and gastrointestinal diseases 42 .…”

Cutaneous tuberculosis: An infrequent manifestation of a common pathogen in South Africa

“…may cause purulent, mass-like lesions with draining sinuses, similar to those described here. 7 Mycobacterial opportunistic diseases such as MTB and nontuberculous mycobacteria are important aetiologies to consider, as well as other acid-fast bacilli, such as Nocardia spp., that may mimic TB presentations. 8 Cutaneous syphilitic gumma, as a manifestation of tertiary syphilis, may also be considered.…”