Primary cutaneous actinomycosis caused by Actinomyces bovis in a patient with common variable immunodeficiency

Mansouri, Parvin; Farshi, Susan; Khosravi, Alireza; Naraghi, Z Safaei

doi:10.1111/j.1346-8138.2010.01165.x

Cited by 8 publications

(12 citation statements)

References 16 publications

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“…Numerous cutaneous infections linked to anti-TNF-α have been reported, including tuberculosis, nocardiosis and sporotrichosis [1], which are differential diagnoses of cutaneous actinomycosis [5,8]. However, so far only three cases of Actinomyces infection observed in patients receiving anti-TNF-α were reported.…”

Section: Discussionmentioning

confidence: 99%

“…Von Graevenitz [11] specified that in his cases, community acquisition was the rule and immunosuppression was rare. Indeed, the risk of developing actinomycosis is reported to be not greater for immunocompromised patients than for immunocompetent ones in the literature [5,6,8]. However, several cases of actinomycosis have been reported in HIV-positive [12,13], leukemic [14] and transplanted [15] patients as well as in patients receiving systemic corticosteroids, chemotherapy [16] or who had common variable immunodeficiency [8] or chronic granulomatous disease [7].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the risk of developing actinomycosis is reported to be not greater for immunocompromised patients than for immunocompetent ones in the literature [5,6,8]. However, several cases of actinomycosis have been reported in HIV-positive [12,13], leukemic [14] and transplanted [15] patients as well as in patients receiving systemic corticosteroids, chemotherapy [16] or who had common variable immunodeficiency [8] or chronic granulomatous disease [7]. Furthermore, cases of progression of systemic infection due to Tropheryma whippleii , a Gram-positive intracellular bacillus related to actinomycetes, have been reported in patients who received anti-TNF-α therapy [17,18].…”

Section: Discussionmentioning

confidence: 99%

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Cutaneous Actinomycosis Associated with Anti-TNF-Alpha Therapy: Report of Two Cases

Breton

Lamblin²,

Pariset³

et al. 2014

Dermatology

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Increased susceptibility to infections is among the main safety concerns raised by anti-TNF-α agents. We describe two cases of cutaneous actinomycosis in patients undergoing anti-TNF-α therapy: a 49-year-old female treated with etanercept for rheumatoid arthritis and a 57-year-old female treated with infliximab for psoriasis. Both patients had discharge with the intermittent presence of sulfur granules occurring at the site of previous surgical wounds. Bacteriological culture demonstrated Actinomyces. Since in both cases laboratory findings and medical imaging ruled out visceral actinomycosis, oral antibiotics were introduced without discontinuing anti-TNF-α. The first patient did not relapse after 2 years. The second one did and received a second course of antibiotics combined with transient interruption of the anti-TNF-α therapy. The risk of developing actinomycosis is reported to be similar in immunocompetent and immunocompromised patients, however cases of cutaneous actinomycosis occurring during anti-TNF-α therapy need to be recognized and may be under-reported.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cutaneous Actinomycosis Associated with Anti-TNF-Alpha Therapy: Report of Two Cases

Breton

Lamblin²,

Pariset³

et al. 2014

Dermatology

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“…El retraso en el diagnóstico fue importante y todos los casos fueron diagnosticados por dermatólogos mediante la cuantificación de inmunoglobulinas séricas. 6,7,8,9,10,11,12,13,14 Cuadro 2. Evaluación de la respuesta específica a anticuerpos contra antígenos polisacáridos (para completar los criterios ESID para IDCV) …”

Section: Posibleunclassified

“…↓ < La mayoría de los pacientes descritos en el Cuadro 3 tuvo respuesta favorable al tratamiento de la manifestación cutánea y remisión de las infecciones con la inmunoglobulina intravenosa, debido a que la etiología era infecciosa o inflamatoria. 6,7,8,9,10,11,12,13,14 Cabe resaltar que un paciente con verrugas en las manos solo tuvo respuesta favorable después de la administración de inmunoglobulina subcutánea en los miembros superiores, pero no así con la administración intravenosa de inmunoglobulina. 10 El paciente con actinomicosis tuvo respuesta favorable a la inmunoglobulina intravenosa asociada con el antibiótico.…”

Section: Nd Nd↓unclassified

Angioedema como única manifestación inicial de hipogammaglobulinemia

López-Rocha

O’Farril-Romanillos

Cerda-Reyes

et al. 2017

RAM

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Common variable immunodeficiency is characterized by hypogammaglobulinemia and the inability to respond to vaccines. Patients mostly manifest infections, however only less than 5 % have pathological conditions as autoimmunity, granulomatous inflammation, and splenomegaly or lymphoproliferative disease among others, without showing infections. We report the case of a woman who debuted with localized cutaneous affection, facial angioedema, without other early symptoms. After diagnosis splenomegaly and bronchiectasis were documented. Angioedema and bronchiectasis responded with IVIG replacement. We also review the dermatological manifestations associated with CVID.

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Cervicofacial Actinomycosis in Children

Şen¹,

Arısoy²,

Starke³

2021

Pediatric ENT Infections

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Actinomycosis is caused by Actinomyces spp., which are Gram-positive, non-acidfast, pleomorphic, non-spore-forming rods. They require anaerobic or microaerophilic environments for growth, and demonstrate branching, often appearing as beaded filaments [5,6]. Gram stain shows varying morphology from diphtheria bacillus-like appearance to a mycelial structure. The organisms are members of the Actinomycetales order, Actinomycetaceae family, Actinomyces genus [2]. Mycobacteria and Nocardia are also included in the Actinomycetales order, and histopathological and clinical differential diagnosis with the members of Actinomyces genus is sometimes difficult [1][2][3].Genus Actinomyces and the very closely related genus Nocardia were previously considered fungi [1,2]. The word Actinomyces means "ray-fungus," and the organisms resemble fungi because of their filamentous appearance. However, Actinomyces spp. are typical bacteria due to the structural features and antimicrobial drug susceptibility. They have much narrower filaments than the hyphae of the fungi. While the filaments of Actinomyces are easily fragmented, the tubular hyphae of the molds do not split and exhibit different branching patterns. Reproduction of Actinomyces is by binary fission, while fungi reproduce by spore and bud formation [2][3][4].Actinomyces spp. are natural members of the oropharyngeal, gastrointestinal, and genitourinary system microbiota [1,5,7]. Dental plaques, carious teeth, periodontal pockets, gingival crevices, tonsillar crypts, and saliva are colonized by Actinomyces species [8,9]. In a pediatric study performed on tonsillectomy tissue, Actinomyces colonization was detected at a rate of 12% [10].Twenty-six of the 49 known Actinomyces species have been implicated in human infections [7]. Actinomyces israelii is the most frequent cause of human disease, and Actinomyces gerencseriae, Actinomyces graevenitzii, Actinomyces meyeri, Actinomyces naeslundii, Actinomyces neuii, Actinomyces odontolyticus, Actinomyces radicidentis, Actinomyces radingae, Actinomyces turicensis, and Actinomyces viscosus were reported as the other leading Actinomyces species causing disease in humans [1,2,6,8]. Although A. israelii is the leading cause of actinomycosis, A. odontolyticus and A. naeslundii are the most common colonizing species in the oral cavity of children [11]. While Actinomyces bovis causes the disease known as "lumpy jaw" in cattle, it has been identified only in a single human case due to possible transmission via a lamb bite [12]. A study conducted in Germany found that A. israelii (42.0%) and A. gerencseriae (26.7%) were the most common species in 1997 culture-positive cases of human cervicofacial actinomycoses [13].Actinomyces spp. are co-pathogens, and require other bacteria to multiply, explaining why they are commonly found in tissues harboring other aerobic and/or anaerobic species. Thus, Actinomyces species are frequently isolated from clinical specimens together with other bacteria of the polymicrobial microbiota. They synergistically inh...

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Primary cutaneous actinomycosis caused by Actinomyces bovis in a patient with common variable immunodeficiency

Cited by 8 publications

References 16 publications

Cutaneous Actinomycosis Associated with Anti-TNF-Alpha Therapy: Report of Two Cases

Cutaneous Actinomycosis Associated with Anti-TNF-Alpha Therapy: Report of Two Cases

Angioedema como única manifestación inicial de hipogammaglobulinemia

Cervicofacial Actinomycosis in Children

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