Musculoskeletal actinomycosis in children: a case report

Abstract

Background Actinomycosis is a rare infectious disease caused by Actinomyces, especially in children. Here, we present a case of musculoskeletal actinomycosis in a 5-year-old girl from China. Case presentation A 5-year-old girl presented with recurrent episodes of fever, pain, erythema, swelling, and festering sores on the right lower extremity, and pus was discharged from a sinus in the right foot. Magnetic resonance imaging (MRI) suggested subcutaneous soft tissue infection and osteomyelitis of the right crus. A bacterial culture of pus extracted from a festering sore on the right popliteal fossa detected the growth of Actinomycetes europaeus. The patient was cured with 7 weeks of treatment with intravenous ampicillin-sulbactam, followed by 6 weeks of treatment with oral amoxicillin-clavulanate with surgical debridement and drainage. There were no symptoms of recurrence during the 15-month period of follow-up. Conclusions Pediatric actinomycosis is a rare and challenging infectious disease. Early accurate diagnosis and optimal surgical debridement are important for the management of pediatric actinomycosis.

Skin and Soft Tissue Actinomycosis in Children and Adolescents

“…Previous to this descriptive cohort, pediatric actinomycosis cases have been limited to case reports or small-size case series. [4][5][6][7][8][9] It is possible that actinomycosis have been more clinically relevant than we understood in the past, due to limitations in microbiologic identification as Actinomyces species can be difficult to grow in culture and standard microbiologic testing can lead to false negative results. 1 The use of newer bacterial identification methods, particularly matrix-assisted laser desorption ionization time of flight, has increased our ability to identify these organisms in clinical specimens.…”