actinomycosis

放线菌病
  • 文章类型: Journal Article
    该病例报告显示,在一名55岁的男性糖尿病患者中,Winkia(放线菌)神经骨髓炎的发生异常。W.neuii是以前放置在放线菌属中的独特物种,具有独特的形态学和临床特征。由放线菌引起的椎体骨髓炎是罕见的,文献中仅报道了一例先前病例。患者在住院期间通过静脉注射头孢曲松和长期口服抗生素方案的组合成功治疗。此病例报告有助于W.neuii周围的知识有限,以及放线菌椎体骨髓炎。
    This case report presents an unusual occurrence of Winkia (Actinomyces) neuii vertebral osteomyelitis in a 55-year-old male patient with diabetes mellitus. W. neuii is a distinct species formerly placed within the Actinomyces genus, exhibiting unique morphological and clinical characteristics. Vertebral osteomyelitis caused by Actinomyces species is rare, with only one prior case reported in the literature. The patient was successfully managed with a combination of intravenous ceftriaxone during hospitalization and an oral antibiotic regimen for an extended period. This case report contributes to the limited body of knowledge surrounding W. neuii, as well as actinomycotic vertebral osteomyelitis.
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  • 文章类型: Case Reports
    支气管内异物抽吸在成人中并不常见,但这是一个危及生命的事件。由异物的慢性保留引起的复发性肺炎通常导致患者的初始医学表现。然而,淋巴浆细胞性支气管炎伴腺瘤性增生和鳞状上皮化生伴模仿肺肿瘤的肺叶支气管完全或部分阻塞在文献中很少见,这种特殊情况经常被误诊。
    我们报告了我们在诊断和管理两名老年复发性肺炎患者方面的经验,住院接受进一步检查。在这两个病人中,没有渴望的历史,在支气管镜检查和柔性冷冻探针再通期间检测到樱桃坑,被脓性分泌物包围,在第一种情况下完全闭塞右上叶,在第二例中,部分左下叶与持续性放线菌病有关,有局部炎症的迹象,在最初的支气管镜检查中模仿肺肿瘤的支气管腺瘤性增生。组织学显示淋巴浆细胞性支气管炎伴腺瘤样增生和鳞状上皮化生,因为异物的慢性保留。
    在高风险患者中出现未解决的慢性咳嗽并伴有复发性肺炎或持续性放线菌病的情况下,应考虑进行支气管镜检查。冷冻探针是治疗因慢性异物滞留引起的气道阻塞的安全可行的方法。此外,这里讨论了相关的发现,同时回顾了慢性异物保留和气道损伤的病理改变和治疗方式。
    UNASSIGNED: Endobronchial 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.
    UNASSIGNED: we 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.
    UNASSIGNED: Bronchoscopy 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.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Systematic Review
    肺放线菌病(PA)是一种罕见的放线菌感染,由于它通常模仿肺癌,因此诊断具有挑战性。
    已发表的病例报告和病例系列的PA怀疑肺癌的患者被考虑,和数据通过PubMed/Medline的结构化搜索提取。
    分析Medline后,回顾了31项研究,从中提取了48例。欧洲报告病例的患病率最高,为45.1%,其次是亚洲(32.2%),美国(19.3%),和非洲(3.2%)。患者平均年龄为58.9岁,75%的患者年龄在50岁以上。男性患者(70%)主要受PA影响。总死亡率为6.25%。只有八种情况,报告了病原体,放线菌是最常见的分离病原体,有3例。根据组织病理学检查,75%的病例被确诊,肺叶切除术10例,最常见的外科手术。在50%的案例中,选择性抗生素是静脉注射和口服青霉素,其次是阿莫西林(29.1%),阿莫西林-克拉维酸,氨苄青霉素,左氧氟沙星,和强力霉素.
    非特异性症状类似于肺癌,导致成像扫描中PA和癌症之间的混淆。放射学技术是有帮助的,但有局限性,当将PA与肺癌混淆时,可能导致不必要的手术。因此,重要的是要提高对PA和肺癌的体征和症状的认识,以防止不良并发症并确保采取适当的治疗措施。
    UNASSIGNED: Pulmonary actinomycosis (PA) is a rare type of Actinomyces infection that can be challenging to diagnose since it often mimics lung cancer.
    UNASSIGNED: Published case reports and case series of PA in patients with suspicion of lung cancer were considered, and data were extracted by a structured search through PubMed/Medline.
    UNASSIGNED: After analyzing Medline, 31 studies were reviewed, from which 48 cases were extracted. Europe had the highest prevalence of reported cases with 45.1%, followed by Asia (32.2%), America (19.3%), and Africa (3.2%). The average age of patients was 58.9 years, and 75% of all patients were above 50 years old. Male patients (70%) were predominantly affected by PA. The overall mortality rate was 6.25%. In only eight cases, the causative agent was reported, and Actinomyces odontolyticus was the most common isolated pathogen with three cases. Based on histopathological examination, 75% of the cases were diagnosed, and the lobectomy was performed in 10 cases, the most common surgical intervention. In 50% of the cases, the selective antibiotics were intravenous and oral penicillin, followed by amoxicillin (29.1%), amoxicillin-clavulanic acid, ampicillin, levofloxacin, and doxycycline.
    UNASSIGNED: The non-specific symptoms resemble lung cancer, leading to confusion between PA and cancer in imaging scans. Radiological techniques are helpful but have limitations that can lead to unnecessary surgeries when confusing PA with lung cancer. Therefore, it is important to raise awareness about the signs and symptoms of PA and lung cancer to prevent undesirable complications and ensure appropriate treatment measures are taken.
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  • 文章类型: Journal Article
    病例报告文献综述。
    回顾放线菌病的表现,特别是下颌骨截骨术。
    文献综述和一例病例报告。
    虽然局部因素继发的轻微感染通常在手术后2-3周出现,晚期感染很少见。宿主因素可能起作用。当放线菌病被诊断出来时,长期使用抗生素是必要的。
    正颌手术后放线菌病非常罕见。它通常发生在下颌骨和矢状分裂之后。与我们的情况一样,放线菌病的出现时间可以从6周到4个月不等。手术后后期发生的感染应怀疑放线菌病进行培养和组织活检。治疗包括切口和引流以及长期抗生素。
    UNASSIGNED: Review of the literature with report of Case.
    UNASSIGNED: To review the presentation of Actinomycosis specifically as it occurs with mandibular osteotomies.
    UNASSIGNED: A review of the literature and report of an additional case.
    UNASSIGNED: While minor infections secondary to local factors are usually seen 2-3 weeks after surgery, late infections are rare. Host factors may play a role. When actinomycosis is diagnosed, long-term antibiotics are necessary.
    UNASSIGNED: Actinomycosis is very rare following orthognathic surgery. It usually occurs in the mandible and following a sagittal split. Time of presentation for actinomycosis can vary from 6 weeks to 4 months as in our case. Infections occurring this late after surgery should be treated with suspicion of actinomycosis obtaining both cultures and tissue biopsies. Treatment involves an incision and drainage and long-term antibiotics.
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  • 文章类型: Case Reports
    背景:放线菌很少引起人类临床相关感染。感染常被误诊为恶性肿瘤,结核病,或者诺卡心症,因此延误了正确的识别和治疗。在这里,我们报告了一例55岁的免疫功能正常的成年人,患有由A.turicensis引起的脑脓肿。对A.turicensis感染进行了系统评价。
    方法:根据系统评价和荟萃分析(PRISMA)指南的首选报告项目对文献进行系统评价。MEDLINE数据库,Embase,WebofScience,CINAHL,搜索了Clinicaltrials.gov和加拿大卫生药物和技术机构(CADTH)的所有相关文献。
    结果:搜索确定了47条符合条件的记录,共67名患者。A.turicensis感染最常见于肛门生殖器区域(n=21),引起急性细菌性皮肤和皮肤结构感染(ABSSSI),包括Fournier坏疽(n=12),肺部感染(n=8),妇科感染(n=6),颈面部感染(n=5),腹腔内或乳腺感染(n=8),尿路感染(n=3),脊柱感染(n=2)中枢神经系统感染(n=2),心内膜炎(n=1)。感染主要表现为脓肿(n=36),伴有或不伴有菌血症(n=7)。超过60%的病例存在发热和局部炎症症状。治疗通常包括手术引流,然后进行抗生素治疗(n=51)。最常见的抗菌治疗包括阿莫西林(+克拉维酸),氨苄西林/舒巴坦,甲硝唑或头孢菌素。百分之八十九的患者完全康复。报告了2例死亡病例。
    结论:据我们所知,我们在此介绍首例由A.turicensis和P.mirabilis引起的脑脓肿。A.turicensis的脑受累很少见,可能是由于血源性传播或连续感染的传播所致。感染可能难以诊断,因此治疗可能会延迟。然而,病原体通常很容易治疗。放线菌病的诊断具有挑战性,需要迅速的微生物学鉴定。手术切除和引流以及抗生素治疗通常可以完全康复。
    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.
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  • 文章类型: Review
    患有COVID-19的个体由于免疫失调而容易发生各种感染。本报告介绍了一名有COVID-19病史的患者上颌骨和窦区放线菌感染的病例。该病例报告强调了由于不同的治疗药物方案而遇到类似于更普遍的真菌感染的破坏性病变时,考虑包括放线菌病在内的细菌感染的重要性。此外,对现有的类似COVID-19后放线菌感染的报道进行了文献综述。
    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.
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  • 文章类型: Case Reports
    足部放线菌病是一种罕见的,慢性,影响皮肤的肉芽肿性传染病,真皮,和皮下组织。它是由真菌或放线菌引起的,导致假瘤外观。这种病理通常进展缓慢,导致延迟诊断。本报告的主要目的是强调这种非常罕见的医疗状况的稀有性和临床意义。
    方法:我们介绍了一个45岁女性的右脚上有肿块的案例。通过切除活检以及联合抗生素治疗来治疗该病症。切除肿块的组织病理学证实存在放线菌病,最终确认诊断。病人的进展令人满意,在2年的随访期内没有观察到复发。
    足部放线菌病是热带和亚热带地区的一种常见病理,气候条件促进了其出现。这是一个慢性的,外源性肉芽肿感染,由真菌(真菌瘤)或细菌(放线菌瘤)引起。当被遗忘时,这些感染会导致并发症,包括骨关节病变,对功能预后有严重影响。脚肿胀的存在应该增加对肌瘤的怀疑作为诊断,证实依赖于组织学分析。管理通常涉及侵入性软组织肿块的积极控制,通常是长期的抗生素治疗。植皮是闭合马杜拉足部缺损的标准方法,由于放线菌病复发的可能性,持续监测是必要的.
    结论:在摩洛哥的背景下,足部放线菌病仍然是零星的。识别这些条件提出了重大的诊断挑战,导致不幸的治疗延误。这些基本上未被识别的病症有可能通过引起骨关节损伤和病变而变得更加复杂。最终恶化了功能前景。观察脚肿胀时,建议及早保持警惕,考虑到足部放线菌病的可能性。明确的诊断需要组织学分析,关键的一步。
    UNASSIGNED: Actinomycosis of the foot is a rare, chronic, granulomatous infectious ailment affecting the skin, dermis, and subcutaneous tissues. It is caused by a fungal or actinomycotic agent, resulting in a pseudotumoral appearance. This pathology typically progresses slowly, leading to delayed diagnosis. The primary objective of this report is to emphasize the rarity and clinical significance of this highly uncommon medical condition.
    METHODS: We present the case of a 45-year-old woman with a mass on the sole of her right foot. The condition was treated through excisional biopsy along with combined antibiotic therapy. Histopathology of the excised mass confirmed the presence of actinomycosis, ultimately confirming the diagnosis. The patient\'s progress was satisfactory, with no recurrence observed over a 2-year follow-up period.
    UNASSIGNED: Actinomycosis of the foot is a common pathology in tropical and subtropical regions where climatic conditions promote its emergence. It is a chronic, granulomatous infection of exogenous origin, caused by either fungal (eumycetoma) or bacterial (actinomycetoma) agents. When left unrecognized, these infections can lead to complications, including osteoarticular lesions, with a severe impact on the functional prognosis. The presence of foot swelling should raise suspicion of mycetoma as a diagnosis, with confirmation relying on histological analysis. Management typically involves the aggressive control of invasive soft-tissue masses, often followed by prolonged antibiotic treatment. Skin grafting is a standard method for closing Madura foot defects, and continuous surveillance is necessary due to the potential for actinomycosis recurrence.
    CONCLUSIONS: In the context of Morocco, actinomycosis of the foot remains sporadic. Identifying these conditions presents significant diagnostic challenges, leading to unfortunate treatment delays. These largely unrecognized conditions have the potential to become more complex by causing osteoarticular damage and lesions, ultimately worsening the functional outlook. Early vigilance is advisable upon observing foot swelling, considering the possibility of actinomycosis of the foot. A definitive diagnosis requires histological analysis, a critical step.
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  • 文章类型: Case Reports
    放线菌病是一种罕见的亚急性或慢性化脓性细菌性肉芽肿性感染性疾病,具有临床异质性。大多数放线菌病是腹外起源的,口颈面部病例占55%,腹肾盂占20%,和胸部占总报告的15%。目前,腹部放线菌病发病率约为每119,000人中1例,在男性中被发现的频率是男性的三倍。我们报告了两种罕见的腹部放线菌病的临床表现,影响肠系膜和腹膜后,分别。
    一名58岁的白人男性出现在我们的诊所,右上腹腹痛。术前评估,虽然没有定论,显示肠系膜肿块浸润右侧和横结肠。患者接受剖腹探查术。部分切除肿块后,组织病理学报告显示肠系膜放线菌病。
    一名40岁的白人男性出现在我们的诊所,抱怨右侧腹股沟区域的一个孔口有粘液脓性物质。经过适当的处理,一个大的腹骨盆,显示腹膜后的星状肿块(75x22.8mm)。手术与适当的抗生素一起用于治疗患者。
    术前怀疑和诊断放线菌病是非常具有挑战性的,误诊率高,往往导致延误治疗。我们的病例报告强调,腹部放线菌病应该始终是鉴别诊断的一部分,尤其是多器官受累的时候。放线菌病的金标准治疗是手术切除并延长抗生素治疗。
    UNASSIGNED: Actinomycosis is an uncommon subacute or chronic suppurative bacterial granulomatous infectious disease with clinical heterogeneity. The majority of actinomycosis cases were of extra-abdominal origin, with oro-cervico-facial cases representing 55%, abdominopelvic representing 20%, and thoracic representing 15% of total reports. Currently, abdominal actinomycosis incidence is approximately 1 case per 119,000 people, being found three times more frequently among males. We report two rare clinical presentations of abdominal actinomycosis affecting the mesentery and the retroperitoneum, respectively.
    UNASSIGNED: A 58-year-old Caucasian male presented to our clinic with abdominal pain in the right upper quadrant. Pre-operative evaluation, although inconclusive, showed a mesocolic mass infiltrating the right and transverse colon. The patient underwent exploratory laparotomy. After partial resection of the mass, the histopathology report demonstrated mesenteric actinomycosis.
    UNASSIGNED: A 40-year-old Caucasian male presented to our clinic complaining about a mucopurulent material from an orifice at the right inguinal region. After appropriate work-up, a large abdominopelvic, stellate mass (75 x 22.8 mm) in the retroperitoneum was revealed. Surgery along with the appropriate antibiotics was used to treat the patient.
    UNASSIGNED: Preoperative suspicion and diagnosis of actinomycosis are very challenging, with a high rate of misdiagnosis often resulting in delayed treatment. Our case reports highlight that abdominal actinomycosis should always be part of differential diagnosis, especially when there is involvement of multiple organs. The gold standard treatment of actinomycosis is surgical excision with prolonged antibiotic treatment.
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  • 文章类型: Review
    背景:放线菌病(ACM)是一种罕见的由放线菌引起的感染性肉芽肿病,aGrampositive,丝状的,腐生细菌.有几种类型的小儿ACM,例如口面(55%)和其他不太常见的形式:腹骨盆和胸部。我们报告了一例16岁的急性阑尾炎患者出现腹部ACM的病例。病例报告之后,我们对发表的小儿阑尾ACM病例进行了简短的文献综述.
    方法:一名16岁男孩出现恶心,呕吐,腹部上部疼痛和发烧(37.5°C)持续24小时。在体检时,患者的上腹部和右下腹部象限触痛。白细胞计数和C反应蛋白(CRP)分别升高至16,300/μL和48.6mg/L。超声检查(US)显示阑尾结石和阑尾壁水肿,局部分层以及阑尾周围炎症。病人接受了典型的阑尾切除术,术后无并发症。组织病理学分析显示阑尾弥漫性透壁中性粒细胞浸润,局灶性伴有坏死和脓肿。有许多由丝状细菌组成的明亮的嗜酸性粒细胞菌落,主要位于粘膜下层。特殊染色剂Grocott-Gomori的甲胺银和革兰氏阳性,并诊断为ACM。
    结论:尽管阑尾炎在普通人群中非常常见,与ACM相关的阑尾炎非常罕见,占0.02%-0.06%,尤其是在儿科人群中。诊断可能非常具有挑战性,因为它们通常表现为非特异性症状,可以形成模仿恶性肿瘤的肿块。虽然罕见,临床医生和病理学家应该意识到这一实体。通过适当的抗生素治疗和手术,可以获得满意的结果和完全治愈。在大多数情况下,如果没有相关的疾病,早期和准确的诊断确保良好的预后。
    Actinomycosis (ACM) is a rare infectious granulomatous disease caused by Actinomyces, a Grampositive, filamentous, saprophytic bacteria. There are several types of pediatric ACM, such as orocervicofacial (55%) and other less common forms: abdominopelvic and thoracic. We report a case of a 16-year-old who presented with abdominal ACM in the setting of acute appendicitis. After the case report, we provide a short literature review of pediatric appendicular ACM cases published.
    A 16-year-old boy presented with nausea, vomiting, pain in the upper part of the abdomen and fever (37.5°C) lasting for 24 hours. On physical examination, the patient`s epigastrium and lower right abdominal quadrant were tender. White cell count and C-reactive protein (CRP) were elevated at 16,300/μL and 48.6mg/L respectively. Ultrasonography (US) showed appendicolith and edema of the appendiceal wall, focally with stratification as well as periappendiceal inflammation. The patient underwent a classic appendectomy, and the postoperative course was without complications. Histopathological analysis showed diffuse transmural neutrophilic infiltration of the appendix, focally with areas of necrosis and abscesses. There were numerous brightly eosinophilic colonies made of filamentous bacteria, located predominantly in submucosa. Special stains Grocott-Gomori`s Methenamine Silver and Gram were positive and a diagnosis of ACM was made.
    Although appendicitis is very common in the general population, appendicitis associated with ACM is very rare, accounting for 0.02% - 0.06%, especially in the pediatric population. Diagnosis can be very challenging because they usually present with non-specific symptoms, and can form masses that mimic malignancies. Although rare, clinicians and pathologists should be aware of this entity. Satisfactory results and complete cure are achieved with adequate antibiotic therapy and surgery. In most cases, if there are no associated diseases, early and accurate diagnosis ensure an excellent prognosis.
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