Difficult Diagnosis Easy Treatment: Actinomycosis

Abstract

Actinomycosis is a chronic, suppurative disease caused by gram-positive anaerobic bacteria from the Actinomycetaceae family. Actinomyces israelii is the most commonly encountered cause of actinomycosis. Other Actinomyces species responsible for actinomycosis are A. odontolyticus, A. meyeri, A. naeslundii, and A. viscosus. Based on the site of involvement, the four most common forms are cervicofascial, abdominal, thoracic and pelvic actinomycosis. Purulent matter, sputum, vaginal discharge, fistulae content or tissue biopsy specimens are generally used to diagnose actinomycosis. However, it is very difficult to identify Actinomyces in these samples due to other filamentous and anaerobic bacteria. In this study, we evaluated actinomycosis cases who were followed up in Ege University Infectious Diseases and Clinical Microbiology Clinic between 2011 and 2016, retrospectively. Cases were evaluated in terms of age, gender, form of application, symptoms, underlying diseases, location of infection, diagnosis, and treatment. Six patients [five women; mean age 52.16 ± 21.21 (min 20-max 83)] were included into this study. Two patients had pelvic, two had cervicofascial, one had skin involvement and one had pulmonary, skin and brain actinomycosis. As a result, actinomycosis is a rare and serious disease. Unless considered in differential diagnosis, appropriate treatment may be delayed. This cohort is one of the largest series reported in Turkey. Being aware of risk factors and clinical forms as well as being skeptical are important fordiagnosis and treatment.

Keywords

• Actinomycosis
• Intrauterine device
• Diagnostic methods
• Risk factors
• Therapy