title: Primary actinomycosis of the breast caused by Actinomyces turicensis with associated Peptoniphilus harei.
abstract: Actinomycosis of the breast is a rare disease which may mimic malignancy in presentation. Clinical presentation may make it difficult to distinguish primary actinomycosis from mastitis and inflammatory carcinoma. A 22-year-old lady presented with a 3-week history of right breast pain and greenish discharge through her nipple piercing. Physical examination revealed a palpable fluctuant lump in the upper inner quadrant of the right breast and a nipple jewelry in-situ in the upper inner quadrant of the right breast with an abscess at the edge of the areola. Needle aspiration was performed and microbiological examination of the aspirate isolated Actinomyces turicensis and Peptoniphilus harei. Actinomycosis of the breast is rare and the specie, Actinomyces turicensis, is even rarer especially in association with Peptoniphilus harei. Actinomyces is a difficult organism to treat due to its relative indolent course with potential scarring and disruption of local tissue. However, surgical intervention could be avoided with an intensive course of high-dose intravenous antibiotics and prolonged oral antibiotics afterwards.
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Royal Gwent Hospital, Newport, UK.
authors.forename: Ganiy Opeyemi
authors.initials: GO
authors.lastname: Abdulrahman
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Royal Gwent Hospital, Newport, UK.
authors.forename: Christopher Alan
authors.initials: CA
authors.lastname: Gateley
mesh_terms: D000190:Actinomyces / Q000302:isolation & purification*; D000196:Actinomycosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001941:Breast Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D060085:Coinfection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D010400:Penicillin G / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D000658:Amoxicillin; D010400:Penicillin G
keywords: Actinomyces turicensis; Breast; Peptoniphilus harei; actinomycosis; breast mass; foreign body