Actinomyces europaeusIsolated from a Breast Abscess in a Penicillin-Allergic Patient

Abstract

This is a case of Actinomyces europaeus in the breast abscess of a penicillin-allergic woman. The mainstay of treatment for actinomycosis is penicillin, and there is a lack of literature describing nonpenicillin treatment options. A 69-year-old woman presented acutely with a breast abscess which was managed with incision and drainage and antibiotic therapy to good response. 21 days after presentation, Actinomyces were grown from the culture of pus, so the patient was recalled and more rigorous treatment and follow-up were initiated. The penicillin allergy led to difficulty in the identification of an appropriate antimicrobial agent that was also logistically feasible to be given on an outpatient IV basis. IV tigecycline followed by oral clarithromycin was found to be effective treatment.

Actinomyces europaeus Brain Abscess in a 69-Year-Old Female Causing Irreversible Neurologic Complications

“…It was successfully treated with abscess drainage and IV ceftriaxone for one month, followed by oral amoxicillin for five months [ 10 ]. An A. europaeus case reported by White and Woodley described a breast abscess in a 69-year-old penicillin-allergic female who was successfully treated with abscess drainage and IV tigecycline, followed by oral clarithromycin [ 11 ].…”

Actinomycosis of the breast and lungs

“…[1][2][3]5 Actinomycosis causing breast abscess is rare in men [8][9][10][11][12] as well as in women. 4,[12][13][14][15][16][17][18][19][20][21][22][23] As a cause of miliary lung lesions [24][25][26][27][28] or of spontaneous sinus tracts exiting the sternum, 29,30 it is even rarer. Yet, all three of these manifestations were evident simultaneously in our patient.…”

Antimicrobial Susceptibility of Clinical Oral Isolates of Actinomyces spp.

“…and genetically closely related species of the order Actinomycetes, such as Streptomyces, generally being multi-drug-resistant, and newly described resistance mechanisms, such as rifampin-inactivating mechanisms, also have been found [27,28]. Other studies have determined that isolates of A. europaeus and A. urogenitalis showed resistance to piperacillintazobactam, cefriaxone, linezolid and clindamycin, respectively [29][30][31].…”