title: Unusual presentation of cervicothoracic actinomycosis complicated by pericardial effusion: a case report.
abstract: Actinomycosis is a chronic-suppurative disease characterized by abscesses and draining sinus tracts, with fibrosis and granulation involving the face and neck and thoracic or pelvic-abdominal regions. Dermatological findings in patients at high risk are the key to the correct diagnosis. Actinomycosis is frequently undiagnosed or misdiagnosed until the correct diagnosis is made after surgical resection. Alcoholic, homeless, and disadvantaged individuals and patients with other factors predisposing to infection including poor dentition, alcoholism, seizures, and trauma are common in the emergency department; thus, emergency physicians should be aware of the different presentations and complications of this disease. The treatment of choice is a high dose of penicillin in conjunction with surgical debridement. The prognosis is excellent with correct diagnosis and therapy.
authors.affiliation: Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota 55416-1829, USA.
authors.forename: K H
authors.initials: KH
authors.lastname: Beier
authors.forename: R A
authors.initials: RA
authors.lastname: Rusnak
mesh_terms: D000197:Actinomycosis, Cervicofacial / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000437:Alcoholism / Q000150:complications; D001706:Biopsy; D015984:Causality; D003937:Diagnosis, Differential; D016724:Empyema, Pleural / Q000000981:diagnostic imaging / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D010510:Periodontal Diseases / Q000150:complications; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000382:microbiology*; D011859:Radiography
chemical_list: D010406:Penicillins