1/4. 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 = physical (Clic here for more details about this article) |
2/4. Actinomycetoma masquerading as an abdominal neoplasm.Despite the fact that infection accompanying actinomycotic organisms is relatively rare, the possibility of such infection should be kept in mind because the organism is known to be commensal in the oral cavity, lungs, and intestinal tract. Abdominal lesions may mimic a neoplasm in many ways--physical findings, clinical course, and roentgenographic changes. Since the bacterium is anaerobic and difficult to grow on culture, one may have to rely on histologic confirmation for diagnosis. The infection can usually be eradicated by large doses of antibiotic (penicillin) over an extended period of time.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/4. Pyogenic liver abscess involving actinomyces: case report and review.We report a case of isolated hepatic actinomycosis and review 35 previously reported cases. Three-fourths of the reported patients were male, and more than one-half were between 30 and 50 years of age. Although some patients had oral disease or intraabdominal infections, the majority of cases were cryptogenic. Common presenting symptoms included fever, abdominal pain, and anorexia with weight loss. Findings on physical examination included pyrexia, abdominal tenderness, and hepatomegaly. leukocytosis with a left shift, anemia, an elevated serum erythrocyte sedimentation rate, and an elevated level of alkaline phosphatase were almost universally present. diagnosis was frequently made at the time of exploratory laparotomy, but percutaneous diagnostic procedures obviated the need for surgery in many recent cases. Microbiological diagnosis involved visualization of branching gram-positive actinomyces organisms or recovery of organisms in anaerobic culture. Treatment most commonly consisted of prolonged administration of penicillin or tetracycline and was associated with an excellent outcome in the majority of cases.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/4. Gastric actinomycosis.A case of actinomycosis of the stomach in a 61-year-old woman is reported. The patient presented to the hospital with a history of epigastric pain, fatigue, poor appetite, constipation and mild fever of 20 days' duration. On physical examination, a tender mass was felt at the epigastrium. Computed tomography (CT) showed a heterogeneously enhanced mass at the posterior wall of the stomach. Upper gastrointestinal series revealed a submucosal mass at the gastric antrum. A malignant tumor was suspected and surgery was recommended. A 5 x 4 x 2 cm mass was found at the posterior wall of the distal gastric antrum. A Billroth II subtotal gastrectomy was performed. Pathologic examination revealed suppuration and sulfur granules in the indurated mass. The patient was subsequently treated with intravenous penicillin-V for 12 days and then with oral penicillin-G for 4 months. She remained well at her last follow-up appointment. Although the initial radiologic findings were nonspecific, CT was of importance in delineating the location and evaluating the extent of the lesion.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |