Cervicofacial actinomycosis: a long forgotten infectious complication of immunosuppression - report of a case and review of the literature.
Actinomycosis is a rare chronic granulomatous infection caused by Gram-positive, non-acid-fast, anaerobic to microaerophilic bacteria.We report a case of cervicofacial actinomycosis in an 86-year-old woman undergoing immunosuppressive therapy with azathioprine and prednisone for rheumatoid arthritis. She underwent a dental treatment several months earlier. The diagnosis of culture-negative actinomycosis was based on histolopathology findings and the isolation of companion bacteria. The patient was treated with amoxicillin-clavulanic acid for 3 months, which produced complete clearance of her cervicofacial actinomycosis.Our case points out the pitfalls of diagnostic procedures in actinomycosis and the ability of this rare disease to mimic other medical conditions.
University Hospital Zurich.
Isabel
I
Kolm
Leonardo
L
Aceto
Michael
M
Hombach
Jivko
J
Kamarshev
Jurg
J
Hafner
Mirjana
M
Urosevic-Maiwald
D000197:Actinomycosis, Cervicofacial / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D000369:Aged, 80 and over; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D019980:Amoxicillin-Potassium Clavulanate Combination; D001379:Azathioprine; D011241:Prednisone