Renal actinomycosis—An unusual cause of a renal abscess

Lin, Chia-Da; Tai, Huai‐Ching; Yu, Chung-Tai; Chang, Shang‐Jen; Hsieh, Cheng‐Hsing; Yang, Stephen Shei‐Dei

doi:10.1016/j.urols.2012.10.001

Cited by 8 publications

(7 citation statements)

References 13 publications

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“…In this situation, inflammatory reactions in adjacent structures like as the retroperitoneum and psoas muscle are frequent. With this pattern the renal tumor is an unlikely diagnosis (4,7,20,23). A CT 2…”

Section: Discussionmentioning

confidence: 99%

“…Actinomycosis is implicated in the loss of host's mucosal barriers and infiltration of bacteria into the adjacent organ or bloodstream. It is characterized as chronic granulomatous and suppurative inflammation, which is usually complicated with abscess formation or sinus tract with sulfur granule discharge (7). Kidney involvement via direct extension from the contiguous structures or hematogenous infection is rare and reported in less than 25 studies since 1990, in English literature (Table 1) (5,.…”

Section: Discussionmentioning

confidence: 99%

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Renal Actinomycosis, A Rare Diagnosis Which Can Clinically Mimic a Malignancy, Case Report and Review of the Literature

Niknejad

Moradi

Niknezhad

et al. 2018

Arch Pediatr Infect Dis

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Introduction: Actinomycosis is an unusual infection, which usually appears in the thoracic, cervicofacial, and abdominal areas. Renal actinomycosis is rare and has not yet been reported in children. Case Presentation: An 8-year-old boy presented with a fever, weight loss, and flank pain two weeks after a sore throat. As the imaging studies were in favor of the malignant tumor of the right kidney, he underwent right radical nephrectomy. Pathologic study revealed Xanthogranulomatous pyelonephritis and actinomyces bacterial colonies. Conclusion: Renal actinomycosis is difficult to diagnose due to its non-specific clinical findings and near similarity to other inflammatory and tumoral conditions. Early diagnosis is important for medical treatment and decrease of unnecessary surgery. Using auxiliary diagnostic methods can be helpful in this aspect. Percutaneous core needle biopsy or fine needle aspiration possesses higher accuracy and specificity in comparison with other methods.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Renal Actinomycosis, A Rare Diagnosis Which Can Clinically Mimic a Malignancy, Case Report and Review of the Literature

Niknejad

Moradi

Niknezhad

et al. 2018

Arch Pediatr Infect Dis

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“…Treatments were heterogeneous as well, including surgical debridement and oral, intravenous and intraperitoneal antibiotics. Only 1 of 20 reported cases resulted in death 21‐39 …”

Section: Discussionmentioning

confidence: 99%

A rare case of Actinomyces skin and soft tissue infection in an end‐stage kidney disease patient with a review of the literature

Hsueh

Kacharam

Shah

2020

Hemodialysis International

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End‐stage kidney disease (ESKD) patients are a commonly overlooked immunocompromised population that places them at risk for rare infections. We describe the case of a 78‐year‐old man with a history of ESKD managed with thrice weekly in‐center hemodialysis who had a prolonged episode of left elbow pain and drainage and was eventually found to have a skin and soft tissue infection from Actinomyces radingae. We review the bacteriology of Actinomyces spp. and the experiences of other providers who have treated actinomycosis in individuals with ESKD. The anatomic sites and demographics of these individuals are heterogeneous, but they all generally require a long antibiotic course with a beta‐lactam and portend to a good prognosis. High index of suspicion is needed to identify rare and atypical infections in the ESKD population.

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“…Sporadically also genitourinary involvement can occur with renal or perirenal masses [20]. Thoracic disease could result from a direct extension into the mediastinum from a cervical-facial infection, or as transdiaphragmatic or retroperitoneal spread from the abdomen.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors show that PET is highly sensitive but not specific for actinomycosis infection, and can be interesting to evaluate the effectiveness of the antibiotic therapy [13]. Another radiological technique with an important role in the diagnostic of this infection is the Gallium-67-citrate scintigraphy [20]. This scintigraphy exhibits an increase uptake of radioactivity in infected foci.…”

Section: Discussionmentioning

confidence: 99%

Intra-abdominal actinomycosis, the great mime: case report and literature review

Montori¹,

Allegri²,

Merigo³

et al. 2015

Emerg Med Health Care

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Background: Actinomycosis is a rare, insidious, infectious disease. Cervicofacial, thoracic and abdominopelvic districts are most commonly involved. Its tendency to involve surrounding structures may mimic a tumor on imaging studies. Early diagnosis, obtained with mini-invasive methods or surgical biopsy, is fundamental to optimize therapeutic approach and to reduce morbidity due to aggressive surgery. Antibiotic therapy is the cornerstone of the treatment of actinomycosis, but the combination with a surgical resection can be necessary in patients who do not respond to medical treatment. Methods: A 66-years old female presented at our attention with an abdominal, retroperitoneal mass found during clinical tests for a vertiginous syndrome. Patient presented with asthenia, anorexia, weight loss, and sacral pain. A retroperitoneal mass, studied with Computed tomography (CT) and Positron emission tomography (PET), was found. No inflammatory signs were found in laboratory tests. Previous core biopsies did not provide the expected results. Cause of that, the patient was prepared for a surgical laparoscopic biopsy and ureteral stenting. After frozen biopsies, histological findings have identified filaments of Actinomyces. No apparent cause of this infection has been identified at first exploration. Results: The patient was treated with antibiotic therapy for three months (Amoxicillin: 1g three times daily). At three months first follow-up, the CT shows the reduction of the retroperitoneal mass and the presence of diverticulosis of the sigma near the mass, in absence of signs of fistulisation. Conclusion: Abdominopelvic actinomycosis should be considered in patients with unusual abdominal mass on abdominal CT or PET. Early diagnosis is necessary to avoid aggressive surgery and its morbidities. Open/laparoscopic surgical biopsy is often necessary to identify the infection. Antibiotic therapy is the standard treatment but surgery can help to optimize medical approach removing necrotic tissue and persistent sinuses.

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Renal actinomycosis—An unusual cause of a renal abscess

Cited by 8 publications

References 13 publications

Renal Actinomycosis, A Rare Diagnosis Which Can Clinically Mimic a Malignancy, Case Report and Review of the Literature

Renal Actinomycosis, A Rare Diagnosis Which Can Clinically Mimic a Malignancy, Case Report and Review of the Literature

A rare case of Actinomyces skin and soft tissue infection in an end‐stage kidney disease patient with a review of the literature

Intra-abdominal actinomycosis, the great mime: case report and literature review

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