1/7. Rhinoorbitocerebral actinomycosis.PURPOSE: To report a case of actinomycotic orbital abscess with subdural empyema and pansinusitis, an unusual presentation of a rarely seen infection. methods: Case report. RESULTS: A 35-year-old man sought treatment for signs and symptoms of an orbital abscess 22 days after a dental extraction. Computed tomography demonstrated a left orbital abscess with left pansinusitis and a large subdural empyema. Surgical clearance of all purulent material was done followed by prolonged penicillin therapy. culture of pus from all sources yielded actinomycosis israelii. At the time of discharge and 1-month follow-up, the patient had 20/20 vision with no neurologic deficits. CONCLUSIONS: In orbital infections with atypical presentations, unusual pathogens should be considered as the causative agents.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/7. actinomycosis abscess of the thyroid gland.OBJECTIVES: To present an unusual case of actinomycosis abscess of the thyroid gland as well as review the history, etiology, pathogenicity and treatment of actinomycosis infections of the head and neck. STUDY DESIGN: Case study. methods: A report of a 39 year-old female status post tooth extraction that developed an actinomycosis abscess of the thyroid. RESULTS: After a thyroid actinomycosis abscess was suggested by physical exam, ultrasound, CT scan and needle aspiration, an otolaryngology consult was obtained. The patient successfully was managed with thyroidectomy and intravenous ceftriaxone. CONCLUSIONS: Although actinomycosis soft tissue infections of the head and neck are relatively uncommon, the head and neck surgeon must include it in the differential diagnosis when clinical presentation raises suspicion. Early biopsy is necessary for appropriate identification of the organism with the appearance of sulfur granules lending a clue to the diagnosis. debridement and/or excision are often necessary for antibiotics to be used successfully. Antimicrobial therapy should be used for six to twelve months to completely eradicate the disease and prevent recurrence.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/7. Chronic postoperative endophthalmitis associated with actinomyces species.actinomyces species, gram-positive, non-spore-forming anaerobic bacilli were isolated from intraocular fluid obtained from four otherwise healthy patients with a delayed onset of postoperative endophthalmitis. One patient had a mixed anaerobic infection with recovery of both actinomyces israelii and propionibacterium acnes. In all four patients, early postoperative visual acuity was good but was eventually markedly reduced by intraocular inflammation that was first observed between 21 days and 4 months following uneventful extracapsular cataract extraction and posterior chamber intraocular lens implantation. inflammation was characterized by anterior segment and vitreous cellular debris in all cases. All eyes responded to therapy that included intraocular, topical, and systemic antibiotics as well as pars plana vitrectomy and partial iridectomy. These cases further illustrate the need for microbiologic investigation, including anaerobic cultures, in all cases of chronic postoperative inflammation following extracapsular cataract extraction, regardless of the time of onset.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
4/7. Importance of histological assessment of dental follicles following extractions.A case is reported of actinomyces being isolated histologically from an enlarged dental follicle surrounding a partially erupted, impacted third molar. This allowed prophylactic therapy to prevent the possible development of cervicofacial actinomycosis.- - - - - - - - - - ranking = 4keywords = extraction (Clic here for more details about this article) |
5/7. actinomycosis of the central nervous system.actinomyces species are rare but treatable causes of CNS infection. Differentiation of actinomycosis from nocardiosis is crucial to the selection of appropriate antimicrobial therapy. A review of 70 cases of CNS actinomycosis was conducted in an effort to characterize clinicopathologic features and identify patients with a high risk of death from infection. Types of lesions included brain abscess (67%), meningitis or meningoencephalitis (13%), actinomycoma (7%), subdural empyema (6%), and epidural abscess (6%). Most infections developed from distant sites (lung, 19 cases; abdomen, four; pelvis, three) or contiguous foci (ear, sinus, and cervicofacial region, 21 cases). For nonmeningitic infection, signs and symptoms were generally those of a space-occupying lesion and were indistinguishable from the manifestations of other pyogenic infections except for a longer interval before diagnosis. risk factors included dental caries; dental infection; recent tooth extraction; head trauma; gastrointestinal tract surgery; chronic otitis, mastoiditis, or sinusitis; chronic osteomyelitis; tetralogy of fallot; and actinomyces infection of an intrauterine device. Optimal management combined adequate surgical drainage with prolonged antibiotic therapy (mean duration, 5 months). overall mortality from treated infection was 28%; 54% of survivors had neurologic sequelae. Features correlated with a poor prognosis were disease onset greater than 2 months before diagnosis and treatment, no antibiotic treatment, no surgery, and needle aspiration drainage of abscess lesions.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/7. Infected total hip arthroplasty due to actinomyces israelii after dental extraction. A case report.Late infection of a total hip arthroplasty after dental extraction has been reported, but never with an organism that is found exclusively in mouth flora. actinomyces israelii is an organism responsible for dental caries. A 61-year-old woman developed an infected total hip arthroplasty after dental work. She denies ever being instructed to take prophylactic antibiotics by her orthopedic surgeon, by her internist, or by her dentist. Considering the extensive morbidity and potential mortality of an infected hip prosthesis, it is essential that all physicians are aware of the indications for antibiotic prophylaxis following joint arthroplasty. Recommendations for antibiotic prophylaxis for dental manipulation are a loading dose of 2.0 g of penicillin v orally or 1.2 million U of aqueous procaine penicillin g with 1.0 gram of streptomycin given intramuscularly 30 minutes before dental work, followed by four doses of 0.5 g of penicillin v orally every six hours.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
7/7. Actinomycotic osteomyelitis of the facial bones and mandible.actinomyces israelii is a part of the human oral flora and thus is more commensal than pathogenic. Oral trauma, accidental or purposeful, can precipitate its introduction into the soft tissues, to which infection is usually confined. The case presented is one in which, over a span of two decades (1956 to 1977), the extraction of a mandibular tooth resulted in a chronic actinomycotic osteomyelitis, destroying first the mandible, then both maxillae, and then the right zygoma, with decreased vision and proptosis despite repeated medical and surgical intervention. Adequate treatment required removal of the sequestrum and excision of all infected granulation tissue, scars, and involucra until healthy bone was exposed. Intravenous penicillin was administered for 2 weeks, followed by a 6-month course of oral penicillin. The patient was followed for 4 years and remained disease free.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |