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Actinomycosis in the tonsils is rare, despite the fact that the bacteria causing it are normally present in the mouth and throat and can colonize the tonsillar crypts, potentially leading to infection even in healthy individuals. Diagnosis is often incidental in tonsillectomy specimens sent to the pathology department for varied diseases. This study over the course of one year examined tonsillectomy samples and tonsillar biopsies that were initially diagnosed with chronic tonsillitis. The specimens were fixed in formalin, embedded in paraffin, and stained using various methods: haematoxylin and eosin (H&E) for general tissue structure, Gomori’s Methenamine Silver (GMS) to highlight fungal and certain bacterial elements, and Periodic Acid-Schiff (PAS) to identify polysaccharides and specific bacteria. The study aimed to detect actinomycosis in tonsillectomy specimens and tonsillar biopsies, as this infection is often found by chance. Using various staining techniques enhances the chances of identifying actinomycosis, which might be missed with routine methods. Accurate diagnosis and treatment depend on recognizing this infection, highlighting the importance of detailed histopathological examination. Out of 23 tonsillectomy specimens and tonsillar biopsies, four cases of tonsillar actinomycosis were identified. Histological examination revealed distinctive eosinophilic granules with peripheral radial projections, accompanied by microabscesses. Although tonsillar actinomycosis is commonly diagnosed incidentally, clinicians should maintain a high level of suspicion in cases of recurrent tonsillitis or unexplained tonsillar hypertrophy. [ABSTRACT FROM AUTHOR]

Background: Non-resolving pneumonia poses a significant clinical challenge. It is common to treat non-resolving pneumonia over an extended period of time, without evaluating the cause of failure or eliciting the exact aetiology. Objective: To determine the aetiology and clinical-radiological profile of non-resolving pneumonia. Materials and methods: Analytical, observational study done among 77 consecutive patients with non-resolving pneumonia, who attended a tertiary care centre over 1 year. Clinical details were obtained using prefixed questionnaires. Necessary diagnostic procedures like bronchoscopy and image guided transthoracic sampling along with histopathological and microbiological investigations were done to obtain final diagnosis. Results: The most common aetiology was lung malignancy (44.2%) followed by chronic infections (40.3%) dominated by tuberculosis (14.3%). Adenocarcinoma (32.5%) was the commonest malignancy presenting as non-resolving consolidation. History of smoking (p value 0.001), chest pain (p value 0.001), and haemoptysis (p value 0.006) was associated with a diagnosis of malignancy. Actinomycosis (7%) had a significant association with chest pain (p value 0.032). Transthoracic image-guided tissue sampling had a high diagnostic yield of 84.8% and bronchoscopy of 66.9%. Conclusion: Malignancy needs to be considered promptly once we encounter with non-resolution of consolidation. The clinical pointers like advanced age, smoking history, symptoms more than 8 weeks, symptoms like chest pain, and haemoptysis mandate evaluation for malignancy in non-resolving pneumonia. The labyrinth of diabetes mellitus impedes the timely resolution of infections. [ABSTRACT FROM AUTHOR]

Pulmonary actinomycosis is an uncommon clinical entity that can be challenging to diagnose due to its non-specific symptomatology. Misdiagnosis and delayed treatment may result in invasive procedures and extended antimicrobial treatment courses. We report a case involving a 65-year-old female with poor oral dentition admitted for acute respiratory failure subsequently found to have a left-sided pleural effusion and perihepatic abscess formation. Cytopathology examination and microbiology studies confirmed the diagnosis of pulmonary actinomycosis. [ABSTRACT FROM AUTHOR]

Actinomycosis is a rare infectious disease characterized by slowly progressive, chronic suppurative lesions, often mistaken for malignancies due to its ability to mimic them. It is caused by Actinomyces bacteria, which are part of the normal flora of the human oropharynx, gastrointestinal, and urogenital tracts. This case report describes a 51-year-old male with a history of mandibular rhabdomyosarcoma presenting with severe shoulder and hip pain, dysphagia, and headaches, initially suspected to be a cancer recurrence. However, after further investigation, including a PET-CT and tonsillectomy, the diagnosis of actinomycosis was confirmed through histopathological examination. The case highlights the diagnostic challenges of actinomycosis, especially in patients with complex clinical histories, emphasizing the importance of considering it as a differential diagnosis in similar presentations. The patient was treated with long-term antibiotic therapy, predominantly beta-lactams, demonstrating the necessity of a comprehensive diagnostic approach and the implications of a delayed diagnosis. This case underscores the critical need for high clinical suspicion and awareness among healthcare professionals regarding the potential for actinomycosis to mimic more common diseases, ensuring timely and accurate treatment. [ABSTRACT FROM AUTHOR]

Mycetoma, commonly known as Madura foot, is a chronic and progressively destructive granulomatous disease caused by a fungus or anaerobic filamentous bacteria that affects the skin, subcutaneous tissue, and bones primarily in tropical and subtropical regions, with males between the ages of 20-40 having occupational exposure to outdoor environments, such as farming, predominantly affected. It is one of the World Health Organization's 17 ''neglected tropical diseases,'' characterized by a clinical trial of localized mass-like soft tissue injury with draining sinuses that discharge grains of infectious material. Here, we present a case report of a 40-year-old male with type 2 diabetes mellitus and a history of fieldwork, who exhibited early manifestations of mycetoma. Unlike the typical diffuse presentation seen in advanced cases, this patient's early presentation prompted diagnostic challenges due to its atypical nature. We highlight the importance of recognizing the early signs of mycetoma, particularly in individuals with predisposing factors such as diabetes and occupational exposure. Diagnostic dilemmas may arise, leading to potential misdiagnosis. Additionally, we emphasize the crucial role of biopsy in confirming the diagnosis, alongside imaging techniques, to facilitate timely intervention and management, thereby significantly impacting patient outcomes.

Numerous conditions can mimic ovarian malignancy. Identifying the origin of a pelvic mass or disseminated peritoneal abnormality on imaging is important to ensure that the patient receives optimal management by the appropriate clinical team. Ovarian cancer mimics include infections and other neoplastic processes, for example, actinomycosis, lymphoma, and sarcoma. We will illustrate intraperitoneal and extraperitoneal ovarian and non-ovarian mimics. Primary peritoneal carcinomatosis mimics include processes such as deep infiltrating endometriosis and rare causes such as gliomatosis peritonei and diffuse peritoneal leiomyomatosis. We aim to illustrate the multimodality key imaging appearances of common and rarer types of mimics. [ABSTRACT FROM AUTHOR]

Actinomycosis is an unusual, chronic granulomatous infection caused by Actinomycetes spp. The organism also causes mycetoma, a neglected tropical disease in endemic regions. We present a very uncommon case of extensive actinomycosis of the soft tissues in the neck with perivertebral extension that showed the dot-in-circle sign on magnetic resonance imaging. A 29-year-old male patient presented with progressively enlarging hard posterior neck swelling of 4 years duration. Subsequently, magnetic resonance imaging showed the dot-in-circle sign in an avidly enhancing infiltrative lesion with extensive involvement of the neck and perivertebral soft tissue. The pathologic examination was in line with actinomycosis. The patient responded to high doses of combination parenteral and oral antibiotics.

Background Methods Results Conclusions Actinomycosis can be caused by periapical endodontic infection, trauma, or surgical dental procedures. Due to its rare occurrence in a healthy adult patient, persistent actinomycotic osteomyelitis around implants presenting as severe peri‐implantitis may be challenging to diagnose.A 26‐year‐old male patient with non‐contributory medical history presented to the Oral and Maxillofacial Surgery Clinic in 2018 with pain and edema associated with endodontically treated maxillary premolar teeth with poor prognosis. Oral examination revealed fair oral hygiene, heavily restored dentition, multiple carious teeth, failing restorations, endodontic treatments in both maxillary quadrants, and normal periodontal examination.Two years following extractions and restoration with implants, the patient returned with a bony sequestrum and fistula in the buccal gingiva adjacent to the implants. The patient reported shifting of implants and slight change in his occlusion. Clinical, radiographic, and endodontic examinations did not demonstrate a clear origin of the fistula. A periodontist was consulted regarding the possibility of peri‐implantitis and tracing of the fistula suggested intraosseous involvement of the implant surface. Flap surgery, biopsy, culture, implant removal, and surgical debridement were performed. Histologic examination revealed colonies of actinomycotic organisms and confirmed likely diagnosis of actinomycosis. The patient was placed on a long course of penicillin VK.The occurrence of actinomycosis in a healthy adult patient is rare. This case report describes persistent actinomycosis presenting as osteomyelitis with severe peri‐implantitis in a healthy patient, which may have been associated with a previously existing periapical endodontic infection. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This case report explores the clinical journey of a patient initially diagnosed with botryomycosis, only to later reveal the underlying and rare condition of actinomycosis. The report highlights the challenges in getting to an accurate diagnosis, emphasizing the importance of considering uncommon pathologies, the utility of multi‐disciplinary teams and clinico‐pathologic correlation in clinical practice. [ABSTRACT FROM AUTHOR]

Actinomycosis is a chronic suppurative bacterial infection commonly seen in the tropics, caused by gram‑positive, anaerobic bacilli of the genus Actinomyces. There are very few reported cases of primary cutaneous actinomycosis. It can mimic mycetoma, tuberculosis, nocardiosis, and botryomycosis. A high index of clinical suspicion is required for diagnosis in the absence of sinuses. Even with repeated attempts, cultures are mostly negative; and hence, histology reveals the diagnosis in most cases. Here, we report an unusual case of primary cutaneous actinomycosis in a 21‑year‑old female patient, following a road traffic accident (RTA). A positive Splendore–Hoeppli phenomenon and special stains demonstrated the ray fungus and helped us reach the diagnosis. The patient was started on oral penicillin G and showed good response. [ABSTRACT FROM AUTHOR]

Esophageal stenosis can cause vomiting or dysphagia in children and is commonly treated with esophageal balloon dilation. However, surgery may be required if the stenosis does not respond to dilation. Although esophageal actinomycosis can cause severe esophageal strictures and be refractory to balloon dilation, it has been reported to respond effectively to antimicrobial therapy in adults. However, the course of the disease and appropriate treatment strategies in children are not well understood. We present a case of a previously healthy 2-year-old boy diagnosed with esophageal stenosis because of actinomycosis. The patient was treated with intravenous penicillin G, followed by oral amoxicillin for 8 weeks and 6 months, respectively. After completion of the antimicrobial treatment, the patient showed improvement in symptoms and endoscopic findings. At the 1-year follow-up, the patient showed consistent weight gain and normal growth without further intervention. This case highlights the importance of considering esophageal actinomycosis as a potential cause of esophageal stenosis in children and the potential effectiveness of anti-microbial therapy in avoiding surgical intervention. [ABSTRACT FROM AUTHOR]

A 3‐year‐old Holstein cow was examined in an intensive system due to unilateral swelling in the mandible. A right mandibular mass was associated with painful mastication and Ptyalism. In palpation, the mass was raised, ulcerated, attached to the mandible bone and firm, approximately 17 × 12 × 10 cm3 in size. The lesion was sampled, and after routine bacteriology and histopathology procedures, the occurrence of lumpy jaw caused by Nocardia farcinica was confirmed. The bacterium was analysed using genome sequencing and new strain called Najm 114. Due to the risk of zoonosis of the isolated agent, the cow was euthanized. This is the first report of lumpy jaw caused by N. farcinica in a cow. This study showed that N. farcinica should be considered a possible etiological agent for lumpy jaw in cattle. [ABSTRACT FROM AUTHOR]

Primary actinomycosis of the appendix is a rare clinical entity. It is generally diagnosed based on histological examination or culture of actinomyces obtained from a peritoneal fluid sampling, and the treatment frequently requires surgical resection. [ABSTRACT FROM AUTHOR]

Copyright of Innere Medizin (2731-7080) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This review focuses on inflammatory diseases of female and male genital organs and discusses their epidemiology, pathogenesis, clinical presentation, and imaging findings. The female section covers pelvic inflammatory disease (PID) primarily caused by sexually transmitted infections (STIs) that affect the uterus, fallopian tubes, and ovaries. Unusual causes such as actinomycosis and tuberculosis have also been explored. The male section delves into infections affecting the vas deferens, epididymis, testes, prostate, and seminal vesicles. Uncommon causes such as tuberculosis, and Zinner syndrome have also been discussed. In addition, this review highlights other conditions that mimic male genital tract infections such as vasculitis, IgG4-related diseases, and sarcoidosis. Accurate diagnosis and appropriate management of these inflammatory diseases are essential for preventing serious complications and infertility. Imaging modalities such as ultrasound, magnetic resonance imaging, and computed tomography play a crucial role in diagnosis. Understanding the diverse etiologies and imaging findings is vital for the effective management of inflammatory diseases of the genital organs. [ABSTRACT FROM AUTHOR]

IntroductionEndobronchial foreign body aspiration is not common in adults, but it is a life-threatening event. Recurrent pneumonias by chronic retention of foreign body often lead to initial medical presentation of the patient. However, lymphoplasmacellular bronchitis with adenomatous hyperplasia and squamous epithelium metaplasia with complete or partial blockage of lobar bronchus mimicking lung tumor is rare in literature, and this particular condition is often misdiagnosed.Case presentationwe report our experience in the diagnostic and management of two elderly patients with recurrent pneumonia, admitted in hospital for further examination. In both patients, with no history of aspiration, the cherry pit was detected during bronchoscopy and recanalization with flexible cryoprobe, surrounded by purulent secretion, occluding completely the right upper lobe in the first case, and partially the left lower lobe associated with persistent actinomycosis in the second case, with signs of local inflammation, bronchial adenomatous hyperplasia mimicking lung tumor at initial bronchoscopic examination. Histology showed a lymphoplasmacellullar bronchitis with adenomatous hyperplasia and squamous epithelium metaplasia because of chronic retention of foreign body.ConclusionBronchoscopy examination should be considered in cases where there is an unresolved chronic cough with recurrent pneumonia or persistent actinomycosis in patients with high risk. Cryoprobe is a safe and feasible approach for treatment of airway obstructions due to chronic foreign body retention. Furthermore, relevant findings are discussed here, along with a review of the pathologic alterations and treatment modalities seen in chronic retention of foreign body and airway injury.

Actinomycosis is an unusual infection that typically appears in the thoracic, cervicofacial, and abdominal areas. However, the occurrence of renal actinomycosis in adults remains rare, with few cases reported since 1990. Actinomycosis is often considered “the most misdiagnosed disease” due to its tendency to be overlooked even by experienced clinicians. Hereby authors report a case of a 55-year-old male with pyrexia of unknown origin and weight loss, presenting with pallor upon general examination. Further investigation revealed microcytic hypochromic anaemia and neutrophilic leukocytosis on peripheral blood smear. A heterogeneous mass with internal vascularity in the left kidney was identified on abdominal ultrasound. Subsequent Computed Tomography (CT) abdomen confirmed an ill-defined lesion in the mid and lower pole of the left kidney, with extrarenal extension into the perinephric space, and a filling defect in the left renal vein. A provisional diagnosis of a left renal tumour infiltrating the spleen and splenic flexure of the colon was made. The patient then underwent a left radical nephrectomy, splenectomy, and limited colonic resection. Histopathological examination confirmed actinomycosis with abscess formation in the kidney and colon. The patient was treated with crystalline penicillin for eight weeks until considered disease-free. Renal actinomycosis poses challenges in diagnosis due to its ambiguous clinical and laboratory features. Often mimicking malignant neoplasms on imaging, it can confuse even experienced clinicians. Early detection is crucial for precise medical intervention and to reduce unnecessary surgeries. [ABSTRACT FROM AUTHOR]

Cerebral actinomycosis is a rare, chronic, but curable bacterial brain infection. We report the case of an 18-year-old male patient with a history of facio-cranial trauma, admitted in our institution with severe headaches and behavioral disorders. Magnetic resonance imaging (MRI) was performed showing the presence of contiguous multiple small round and ovoid lesions in the right frontal lobe with “the dot in circle” appearance. The diagnosis of cerebral actinomycosis was confirmed by histological study of the biopsy sample. Despite it being a rare condition, it is important to consider this diagnosis in patients with atypical post-traumatic neurological symptoms.

Abstract Background Actinomyces turicensis is rarely responsible of clinically relevant infections in human. Infection is often misdiagnosed as malignancy, tuberculosis, or nocardiosis, therefore delaying the correct identification and treatment. Here we report a case of a 55-year-old immunocompetent adult with brain abscess caused by A. turicensis. A systematic review of A. turicensis infections was performed. Methods A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases MEDLINE, Embase, Web of Science, CINAHL, Clinicaltrials.gov and Canadian Agency for Drugs and Technology in Health (CADTH) were searched for all relevant literature. Results Search identified 47 eligible records, for a total of 67 patients. A. turicensis infection was most frequently reported in the anogenital area (n = 21), causing acute bacterial skin and skin structure infections (ABSSSI) including Fournier’s gangrene (n = 12), pulmonary infections (n = 8), gynecological infections (n = 6), cervicofacial district infections (n = 5), intrabdominal or breast infections (n = 8), urinary tract infections (n = 3), vertebral column infections (n = 2) central nervous system infections (n = 2), endocarditis (n = 1). Infections were mostly presenting as abscesses (n = 36), with or without concomitant bacteremia (n = 7). Fever and local signs of inflammation were present in over 60% of the cases. Treatment usually involved surgical drainage followed by antibiotic therapy (n = 51). Antimicrobial treatments most frequently included amoxicillin (+clavulanate), ampicillin/sulbactam, metronidazole or cephalosporins. Eighty-nine percent of the patients underwent a full recovery. Two fatal cases were reported. Conclusions To the best of our knowledge, we hereby present the first case of a brain abscess caused by A. turicensis and P. mirabilis. Brain involvement by A. turicensis is rare and may result from hematogenous spread or by dissemination of a contiguous infection. The infection might be difficult to diagnose and therefore treatment may be delayed. Nevertheless, the pathogen is often readily treatable. Diagnosis of actinomycosis is challenging and requires prompt microbiological identification. Surgical excision and drainage and antibiotic treatment usually allow for full recovery.

Actinomycosis is a rare disease. Its diagnosis is challenging clinically as it mimics many other infectious diseases and neoplasms. In this scenario, a simple timely biopsy can come to the clinician’s rescue. Actinomycosis can be reliably diagnosed on histopathological examination accompanied by special stains without losing much time. Culturing this organism is a tedious job in view of its fastidious nature and requires a long waiting time. Polymerase chain reaction (PCR) can be useful and is less time‑consuming, but histopathology is more cost‑effective in our country like India. This case report emphasizes the fact that a rare possibility of actinomycosis should also be kept in mind even in immunocompetent individuals in rare sites like gingiva even if there are no discharging sinuses noted clinically. Actinomycosis requires long‑duration antibiotic treatment, so if diagnosis time is reduced, timely treatment of actinomycosis can be started and complications can be prevented. [ABSTRACT FROM AUTHOR]

Actinomycosis, an oral cavity commensal, causes cervicofacial infection in patients associated with an immunosuppression state and local mucosal injuries. Bone involvement by this commensal is rare. In the present case, we report a case of left peri mandibular soft tissue, soft to firm, tender swelling in a 39‐year‐old immunocompetent male diagnosed as Actinomycosis infection on fine needle aspiration cytology (FNAC) and cell block preparation. [ABSTRACT FROM AUTHOR]

The purpose of this article is to try to determine the probable cause of the disease from which the study animal suffered. The skeletal material included a caudal fragment of a cattle mandible. The specimen, exhibiting chronic disease was separated from approximately 10,000 early medieval cattle remains discovered during excavations of the former Kruszwica stronghold. The bone was underwent macroscopic, radiological and histopathological examination. Location, macroscopic, microscopic and X-ray images of the lesions within the examined mandible indicate it could have been caused by the actinomycosis. In the face of infection, no effective therapies were undertaken in the Middle Ages. Descriptions of lumpy jaw in the paleopathological literature are rare. This disease, due to its background and course, eliminated animals from breeding for centuries until the era of antibiotics. The case described in our paper is in an advanced stage, but its adult age suggests that efforts were possibly made to keep the cow alive as long as possible, indicating the significant economic importance of the animal. This analysis is limited by the absence of other anatomical elements of the affected animal, which impacts the interpretation of the palaeopathological bone. It is recommended that similar studies are conducted on better preserved and more numerous cattle assemblages. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Actinomycosis is a clinically significant but uncommon infectious disease caused by anaerobic commensals of Actinomyces species, and the incidence of thoracic empyema is rare. We report an extremely rare case of empyema caused by Actinomyces naeslundii (A. naeslundii). Case Report: A 39-year-old man presented to our hospital with fever and dyspnea. He had massive pleural effusion and was diagnosed with a left lower-lobe abscess and left thoracic empyema. Thoracic drainage was performed and Ampicillin/Sulbactam was administered for 3 weeks. Four years later, the patient presented with back pain, and chest X-ray showed increased left pleural effusion. After close examination, malignant pleural mesothelioma was suspected, and computed tomography-guided needle biopsy was performed, which yielded a viscous purulent pleural effusion with numerous greenish-yellow sulfur granules. A. naeslundii was identified through anaerobic culture. Thoracoscopic surgery of the empyema cavity was conducted, and Ampicillin/Sulbactam followed by Amoxicillin/Clavulanate was administered for approximately 6 months. No recurrence has been observed for 1 year since the surgical procedure. Conclusions: Actinomyces empyema is a rare condition, and this case is the second reported occurrence of empyema caused by A. naeslundii. The visual identification of sulfur granules contributed to the diagnosis. Long-term antibiotic therapy plays a crucial role in treatment. [ABSTRACT FROM AUTHOR]

The article describes the case of a six-year-old girl with schizencephaly, shunted hydrocephalus, epilepsy, global development delay, diabetes insipidus, and spastic quadriplegic cerebral palsy. Topics discussed include findings on her medical examination, major categories of the differential diagnosis for a child with acquired chest wall mass, and final diagnosis of thoraco-abdominal actinomycosis with chest wall invasion.

Background: Actinomyces turicensis is rarely responsible of clinically relevant infections in human. Infection is often misdiagnosed as malignancy, tuberculosis, or nocardiosis, therefore delaying the correct identification and treatment. Here we report a case of a 55-year-old immunocompetent adult with brain abscess caused by A. turicensis. A systematic review of A. turicensis infections was performed. Methods: A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases MEDLINE, Embase, Web of Science, CINAHL, Clinicaltrials.gov and Canadian Agency for Drugs and Technology in Health (CADTH) were searched for all relevant literature. Results: Search identified 47 eligible records, for a total of 67 patients. A. turicensis infection was most frequently reported in the anogenital area (n = 21), causing acute bacterial skin and skin structure infections (ABSSSI) including Fournier's gangrene (n = 12), pulmonary infections (n = 8), gynecological infections (n = 6), cervicofacial district infections (n = 5), intrabdominal or breast infections (n = 8), urinary tract infections (n = 3), vertebral column infections (n = 2) central nervous system infections (n = 2), endocarditis (n = 1). Infections were mostly presenting as abscesses (n = 36), with or without concomitant bacteremia (n = 7). Fever and local signs of inflammation were present in over 60% of the cases. Treatment usually involved surgical drainage followed by antibiotic therapy (n = 51). Antimicrobial treatments most frequently included amoxicillin (+clavulanate), ampicillin/sulbactam, metronidazole or cephalosporins. Eighty-nine percent of the patients underwent a full recovery. Two fatal cases were reported. Conclusions: To the best of our knowledge, we hereby present the first case of a brain abscess caused by A. turicensis and P. mirabilis. Brain involvement by A. turicensis is rare and may result from hematogenous spread or by dissemination of a contiguous infection. The infection might be difficult to diagnose and therefore treatment may be delayed. Nevertheless, the pathogen is often readily treatable. Diagnosis of actinomycosis is challenging and requires prompt microbiological identification. Surgical excision and drainage and antibiotic treatment usually allow for full recovery. [ABSTRACT FROM AUTHOR]

Primary Gastric Actinomycosis is extremely rare. We report two cases of Primary Gastric Actinomycosis. First case, a 90-year-old gentleman with multiple co-morbidities came with post prandial non radiating epigastric pain for 2 weeks. Gastroscopy showed a submucosal gastric SOL. Endoscopic ultrasonography-guided Gastric SOL aspiration grew Actinomyces naeslundii. Second case, a 56 year old gentleman, known diabetic came with abdominal pain for 5 to 6 months and weight loss. Ultrasound abdomen revealed pyloric thickening. Upper gastrointestinal endoscopy showed gastric ulcer. Biopsies were suggestive of Actinomycosis. Cautious used of long term proton pump inhibitor in elderly and immunosuppressed individual. All efforts should be made to acquire the appropriate tissue sample for histopathology examination and culture. All actinomycosis infections need not have Sulphur pigments. Actinomycosis has a good prognosis with appropriate treatment. [ABSTRACT FROM AUTHOR]

Actinomycosis is a chronic suppurative infection caused by gram-positive bacteria, Actinomyces, which commonly colonize the oral cavity, urogenital tract and gastrointestinal tract. It causes opportunistic infection where the mucosal barrier is compromised and is often misdiagnosed as malignancy. We report a case of a 58-year-old female with severe abdominal pain and a palpable tender mass in the left lower quadrant. Computed tomography scan with contrast showed thickening of the transverse, descending to sigmoid colon wall and intense contrast enhancement resembling colitis with mesenteritis. At laparotomy, we found an adherent mass involving sigmoid colon with adjacent small bowel and peritoneum. We decided to perform adhesiolysis and Hartmann procedure. The culture result was negative, whereas the biopsy of sigmoid colon revealed characteristic sulfur granules of actinomycosis colony. Intravenous antibiotic combination of ceftazidime and metronidazole was administered for 14 days followed by complete resolution of symptoms. Histopathological and bacteriological examinations are keys to diagnose actinomycosis. Patients require long-term antibiotic therapy, but surgery is often required because preoperative diagnosis is difficult. Main novel aspects? We presented the rare case of intra-abdominal actinomycosis in Indonesia The case was challenging to diagnose pre-operatively based on physical examination and Exploratory laparotomy revealed pseudotumor mimicking advanced stage of colon neoplasm [ABSTRACT FROM AUTHOR]

Copyright of Epidemiological Review / Przegląd Epidemiologiczny is the property of National Institute of Public Health - National Institute of Hygiene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Key Clinical Message This case report explores the clinical journey of a patient initially diagnosed with botryomycosis, only to later reveal the underlying and rare condition of actinomycosis. The report highlights the challenges in getting to an accurate diagnosis, emphasizing the importance of considering uncommon pathologies, the utility of multi‐disciplinary teams and clinico‐pathologic correlation in clinical practice.

Actinomyces species are recognized as common mucosal bacteria in humans and as a newly discovered source of infection. Since its discovery in 1995, the subspecies Actinomyces turicensis has been reported as the causative pathogen of numerous infections. Only two instances of A. turicensis-related empyema, however, have been documented in the literature as of late. We report a unique case of polymicrobial empyema caused by A. turicensis shortly after a COVID-19 without any clear risk factors for anaerobic aspiration, along with a brief review of the literature. Tetracycline was successfully used for the first time to treat A. turicensis empyema, following chest drainage.

Actinomyces species are recognized as common mucosal bacteria in humans and as a newly discovered source of infection. Since its discovery in 1995, the subspecies Actinomyces turicensis has been reported as the causative pathogen of numerous infections. Only two instances of A. turicensis-related empyema, however, have been documented in the literature as of late. We report a unique case of polymicrobial empyema caused by A. turicensis shortly after a COVID-19 without any clear risk factors for anaerobic aspiration, along with a brief review of the literature. Tetracycline was successfully used for the first time to treat A. turicensis empyema, following chest drainage. [ABSTRACT FROM AUTHOR]

Primary actinomycosis of the appendix is a rare clinical entity. It is generally diagnosed based on histological examination or culture of actinomyces obtained from a peritoneal fluid sampling, and the treatment frequently requires surgical resection. [ABSTRACT FROM AUTHOR]

Actinomycosis remains a rare and often underdiagnosed cause of appendicitis with only 10% of cases diagnosed prior to surgery. It is an important cause to consider particularly in the setting of an indolent infection with nonspecific symptoms. We present a 22 years old male who presented with 3 weeks history of lower abdominal pain who underwent laboratory investigations and imaging studies suggestive of acute appendicitis. He underwent an emergency laparoscopic caecectomy with histopathology of the specimen suggestive of actinomycosis. He recovered well postoperatively and was discharged home with a prolonged course of oral penicillins. Preoperative diagnosis of actinomycosis is uncommon and accounts for ~10% of cases. Definitive diagnosis is usually through histopathology or tissue/fluid culture. Treatment usually involves a combination of surgical resection and antibiotic therapy with a success rate of >90%. [ABSTRACT FROM AUTHOR]

Actinomycosis is a rare infectious disease characterized by slowly progressive, chronic suppurative lesions, often mistaken for malignancies due to its ability to mimic them. It is caused by Actinomyces bacteria, which are part of the normal flora of the human oropharynx, gastrointestinal, and urogenital tracts. This case report describes a 51-year-old male with a history of mandibular rhabdomyosarcoma presenting with severe shoulder and hip pain, dysphagia, and headaches, initially suspected to be a cancer recurrence. However, after further investigation, including a PET-CT and tonsillectomy, the diagnosis of actinomycosis was confirmed through histopathological examination. The case highlights the diagnostic challenges of actinomycosis, especially in patients with complex clinical histories, emphasizing the importance of considering it as a differential diagnosis in similar presentations. The patient was treated with long-term antibiotic therapy, predominantly beta-lactams, demonstrating the necessity of a comprehensive diagnostic approach and the implications of a delayed diagnosis. This case underscores the critical need for high clinical suspicion and awareness among healthcare professionals regarding the potential for actinomycosis to mimic more common diseases, ensuring timely and accurate treatment.

Pulmonary actinomycosis is an uncommon clinical entity that can be challenging to diagnose due to its non-specific symptomatology. Misdiagnosis and delayed treatment may result in invasive procedures and extended antimicrobial treatment courses. We report a case involving a 65-year-old female with poor oral dentition admitted for acute respiratory failure subsequently found to have a left-sided pleural effusion and perihepatic abscess formation. Cytopathology examination and microbiology studies confirmed the diagnosis of pulmonary actinomycosis.

Individuals with COVID-19 are prone to a variety of infections due to immune dysregulation. The present report presents a case of actinomycotic infection in the maxillary bone and sinus region in a patient with a history of COVID-19. This case report highlights the importance of considering bacterial infections including actinomycosis when encountering destructive lesions resembling more prevalent fungal infections due to different therapeutic medication protocols. In addition, a literature review of the existing reports of similar post-COVID-19 actinomycotic infection is presented. [ABSTRACT FROM AUTHOR]

Actinomycosis is an uncommon, subacute to chronic, suppurative bacterial infection caused by Actinomyces Israelii. About 3% of all actinomycosis cases occur in the tongue, often affecting adult patients (mean age, 50 years). The clinical characteristics of actinomycosis can resemble malignant or benign tumors, and other infectious diseases. A 56-year-old woman was referred presenting an ulcerated lesion on the tongue 1 year ago. Intraoral examination revealed an edematous nodular lesion with an ulcerated surface, slightly symptomatic, on the midline dorsum of posterior tongue, suggesting nodular median rhomboid glossitis. Cytology smear was negative for fungus. After excisional biopsy, histopathological examination showed a chronic inflammatory infiltrate supported by a fibrovascular connective tissue stroma, and at the deepest part, broad basophilic areas surrounded by neutrophils, containing numerous filamentous bacilli, which were highlighted by Gram and Groccott-Gomori staining. The final diagnosis was lingual actinomycosis. Oral amoxicillin treatment (8/8 h for 2 weeks) was started, and after 1-month complete resolution was observed. Lingual actinomycosis is a rare lesion that must be recognized by dentists, because its early diagnosis and correct treatment reduce the possibility of a clinical complication that compromises the patient's quality of life. Noteworthy, when located on the midline dorsum of posterior tongue, actinomycosis can simulate nodular median rhomboid glossitis, expanding its spectrum of clinical differential diagnosis. [ABSTRACT FROM AUTHOR]

Cervicofacial actinomycosis being one of the unusual infections is of high relevance to a head and neck onco-surgeon. As the diagnosis may be made difficult by its nature to mimic malignancy and egregiously low culture sensitivity, the differential diagnosis for a lesion appearing to be malignant after irradiation does not usually include actinomycotic infection. Treatment usually requires a long-term antibiotic course after confirmation with histopathology, albeit surgical debridement is required in selective cases. Here we report two cases that were clinico-radiologically diagnosed as osteoradionecrosis and histopathological analysis done to rule out cancer recurrence. Unanticipated, they turned out to be cervicofacial actinomycosis, subsequently treated with long-term antibiotics following which the infection subsided. [ABSTRACT FROM AUTHOR]

Macropod progressive periodontal disease (MPPD), known as Lumpy Jaw, poses a persistent and potentially fatal threat in Western gray kangaroos when they are kept in captivity. Such a condition leads to the development of osteomyelitis and sepsis in Western gray kangaroos (Macropus fuliginosus). This case study presented the inaugural examination of hematological and biochemical aspects of MPPD with a progression toward sepsis in a captive environment. The primary objective of this research was to pinpoint hematological and biochemical indicators associated with severe MPPD in a Western gray kangaroo held in captivity. The study employed various methods, including clinical, radiographical, hematological, and biochemical analyses, as well as microbiological study methods. The case was a 2.5-year-old male wild Western gray kangaroo with fever (39.7 ℃), dehydration, dyspnea, tachycardia, and involuntary jaw clenching due to stress and agitation. The kangaroo had a history of lethargy, anorexia, swelling of the soft tissues of the lower jaw on the left side, and tenderness during palpation. A radiograph of the head revealed mandible proliferative lesions. The hematological and biochemical examinations indicated an increase in the total count of leucocytes, level of neutrophils, number of erythrocytes, hematocrit level, and lymphopenia. Increased activity of alkaline phosphatase, amylase, and creatinine elevated azotemia. There was a decrease in the content of albumin, glucose, and total bilirubin. The bacteria, consisting of Fusobacteriaceae spp., Porphyromonadaceae spp., and Bacteroidaceae spp., were found and identified in all samples. However, this comprehensive diagnosis of MPPD based on clinical signs, radiography, and especially hematological and biochemical parameters of the septic process can be helpful in diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Although thought to be uncommon, it is believed that cervicofacial actinomycosis is underreported due to frequent misdiagnosis. It has been called the "most misdiagnosed disease by experienced clinicians". A wide range of dental procedures or trauma, including tooth eruption, may precipitate actinomycosis by enabling microorganisms to penetrate the deeper tissue layers via an entry point. This infective disease is significant due to its potentially aggressive and locally destructive nature. This case describes a patient diagnosed with cervicofacial actinomycosis. Her history prior to this was significant for proliferative verrucous leukoplakia, and T4aN0M0 (AJCC 7th Edition) squamous cell carcinoma of the right hard palate for which she received surgery and post-operative radiotherapy. The mechanism of actinomycotic infection, its presentation, differential diagnosis, and management is discussed, with review of the relevant literature. This case highlights an unusual case of cervicofacial actinomycosis and demonstrates the complexities in reaching a definitive diagnosis in cases of osteomyelitis and osteoradionecrosis with significant bacterial burden. [ABSTRACT FROM AUTHOR]

A 66-year-old male patient diagnosed with small-cell lung cancer received chemotherapy and immunotherapy, resulting in successful tumor control. However, the patient subsequently experienced a fever and rapid progression of the pulmonary cavity. Despite sampling bronchoscopic bronchoalveolar lavage fluid for targeted next-generation sequencing (tNGS), the cause remained unidentified. Adding bronchoalveolar lavage fluid to sense metagenomic next-generation sequencing (mNGS) confirmed the infection caused by actinomycetes. The patient's condition improved after active anti-infection treatment. This case was further analyzed and discussed through a comprehensive literature review, focusing on molecular microbiological diagnosis and treatment processes. The points outlined were as follows: the advancement of molecular microbiology has gradually reduced the challenges associated with diagnosing rare infectious diseases such as pulmonary actinomycosis. Additionally, in immunodeficient individuals, certain infectious diseases with a chronic course may exhibit acute and aggressive characteristics, which is of concern to all colleagues. Currently, tNGS and mNGS are widely employed in clinical settings as practical tools for diagnosing infectious diseases. Notably, these two methods are not substitutes for each other but complement each other. [ABSTRACT FROM AUTHOR]

Objective: Rare disease. Background: Actinomyces, a filamentous, branching, anaerobic gram-positive bacillus, typically found as a commensal organism in the oral cavity, can lead to rare chronic bacterial infections in various anatomical regions. Chest wall involvement represents an uncommon presentation, posing significant diagnostic challenges. This report focuses on the case of a 13-year-old boy presenting with chest wall actinomycetoma that closely resembled Ewing sarcoma on imaging. Case Report: We present the case of a 13-year-old male with no previous medical history who presented to the Emergency Department with progressive left-sided chest pain following a sports-related fall. Physical examination revealed mild swelling and tenderness on the left anterior chest wall. A chest computed tomography (CT) scan revealed a large tumor involving the lower left chest wall, suggesting Ewing sarcoma. However, a histopathological examination unexpectedly confirmed actinomycosis of the chest wall. Intravenous penicillin G was promptly initiated for 4 weeks. A follow-up CT scan after 4 weeks of therapy demonstrated a significant response with notable reduction in the size of the chest wall mass. The patient then continued with maintenance therapy using oral amoxicillin for 12 months. Throughout this period, complete resolution of the chest wall mass occurred, with no significant adverse events or complications observed. Conclusions: This case highlights the importance of considering uncommon differential diagnoses like chest wall actinomycosis in patients presenting with chest wall masses. The diagnostic complexities associated with this rare condition emphasize the need for a comprehensive evaluation strategy, incorporating histopathological examination and imaging. [ABSTRACT FROM AUTHOR]

Gerald R. Ford was the 38th president of the United States. He was appointed as vice president by Richard Nixon in 1974 upon the resignation of Spiro T. Agnew. In the midst of the Watergate Crisis, Nixon resigned making Ford the only president to serve without being elected as either president or vice president. In the year 2000, 13 years after his abbreviated term in office, he was attending the Republican National Convention in Philadelphia where he developed pain in his tongue, slurring of his speech, and signs of a stroke. He was taken to the emergency room of Hahnemann University Hospital where a CT scan showed a posterior circulation stroke. Within 24 hours, all of Ford's symptoms improved except for his tongue pain and speech. An MRI of the head and neck showed a tongue mass and he was taken to the operating room where an abscess was found. The bacteriology confirmed actinomycosis of the tongue and Ford rapidly improved after the incision and drainage. This paper will review the clinical course of Gerald Ford's lingual actinomycosis and will discuss this rare condition. [ABSTRACT FROM AUTHOR]

Key Clinical Message: We reported herein a case of isolated cerebral actinomycosis in a 54‐year‐old immunocompetent man. Brain MRI showed a left frontal intra‐axial lesion and perilesional edema. We performed an open biopsy of the left frontal enhancing lesion. Intraoperative findings showed a yellowish, malleable, and capsulated lesion that was well defined with surrounding normal tissue within pus inside and lacked any necrotic content. MR spectroscopy showed a high level of choline, lactate, and lipid peaks with a choline/N‐Acetylaspartic acid ratio of 1.8. The diagnosis was confirmed histologically, and the patient was treated successfully for 3 months after surgical aspiration. Surgical management allowed to confirm the diagnosis with a shorten antibiotics, a rapid resolution of symptoms, and a complete recovery. [ABSTRACT FROM AUTHOR]

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Background Constrictive pericarditis associated with actinomycosis infection is a rare and challenging diagnosis due to its insidious manifestation. We describe the successful treatment of pericardial infiltration and constriction due to actinomycosis. Case summary A 50-year-old Aboriginal man presented with insidious onset of fatigue, dyspnoea, pleuritic chest pain, fever, drenching sweats, severe exercise intolerance to 50 m, and recurrent itchy skin lesions over 8 months. Prior investigations, including serial fluorodeoxyglucose (FDG)-Positron emission tomography scans, found a progressively enlarging, metabolically active anterior mediastinal mass with two biopsies on separate occasions showing no malignancy, granulomas, tuberculosis, or other pathology. Screening for infective, autoimmune, and connective tissue disease was negative. A transthoracic echocardiogram (TTE) showed fibrinous pericarditis with extensive myocardial tethering and constrictive physiology confirmed on heart catheterization. A pericardial biopsy showed inflammatory tissue only. Biopsy of a skin lesion on the buttock showed abscess formation with Splendore Hoeppli phenomenon with Gram-positive and Grocott-positive filamentous bacteria suggestive of actinomyces, confirmed by 16S rRNA gene sequencing. He was diagnosed with cardiac actinomycosis, likely due to mediastinal infiltration from a lung infection, with haematogenous spread and treated with Penicillin G with adjunctive high-dose steroid therapy with resolution of symptoms and marked improvement in TTE features of constriction after 6 weeks. Discussion Actinomycosis is an extremely rare cause of pericardial infiltration and constriction yet highly sensitive to penicillin, highlighting the importance of accurate diagnosis. Corticosteroids are a useful adjunct to prevent chronic constrictive pericarditis and to avoid the high morbidity and mortality associated with pericardiectomy. [ABSTRACT FROM AUTHOR]

Gingival abscess is a localized, acute inflammatory lesion which is caused by various factors that include microbial plaque infection, foreign body impaction, and trauma. Management includes a simple incision and draining of the purulent exudate along with systemic antibiotics in most of the cases. This article reports a case of a 16-year-old female patient, with a chief complaint of painful and swollen gums in her lower right front tooth region of the jaw along with fever for the past 5 days. Emergency treatment of abscess drainage was done on day 1. On 5th day of review, the case presented with persistent signs of gingival inflammation in relation to 43 to 41. Considering the provisional diagnosis as dentigerous cyst with persistent gingival abscess, definitive treatment was performed by transalveolar extraction of the impacted canine and debridement of the osseous lesion. The histologic analysis of the lesion exhibited foci of eosinophilic coagulum-like areas with epicentric and radiating filamentous appearance at the periphery, which is suggestive of an inflamed dentigerous cyst with actinomycosis infection of periodontium. [ABSTRACT FROM AUTHOR]