Case Reports in Clinical Practice (Jan 2019)
A Long-Term Chronic Scrotal Actinomycosis in a Middle-Aged Patient in Kerman
Abstract
Actinomyces species are non-spore forming Gram-positive bacilli. They are part of human/animal’s micro-flora and are also among soil inhabitants. Actinomycosis is an opportunisic, indolent, slow growing, chronic progressive and granulomatous infection caused primarily by Actinomyces israelii. Less than 100 cases of Actinomyces nueii isolates have been reported in the literature. Our case is a 47-year-old man who recognized two painless nodules in his scrotum six months after military training. He did not reveal his problem. Ten years later, both lesions inflamed and ruptured. He had been treated empirically. About 15 years later, the inflammation reappeared along with general sign and symptoms of acute disseminated infectious disease. In microbiology examination, Actinomyces neuii was isolated from purulent aspirate of scrotal lesions. Along with surgical drainage of abscess, he was treated with antibiotics. Physicians mus remember that chronic, not purulent lesions of Actinomyces may be misdiagnosed with malignancies, too. Some patients like our case may ignore mild sexual disease for its anatomic site. This ignorance may lead to a severe infection.
