Cervicofacial actinomycosis: a long forgotten infectious complication of immunosuppression - report of a case and review of the literature.

Abstract

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.

• Authors: Isabel Kolm, Leonardo Aceto, Michael Hombach, Jivko Kamarshev, Jurg Hafner, Mirjana Urosevic-Maiwald
• Journal: Dermatology online journal (Dermatol Online J) Vol. 20 Issue 5 Pg. 22640 (May 16 2014) ISSN: 1087-2108 [Electronic] United States
• PMID: 24852779 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Immunosuppressive Agents
• Amoxicillin-Potassium Clavulanate Combination
• Azathioprine
• Prednisone

Topics

• Actinomycosis, Cervicofacial (diagnosis, drug therapy, immunology)
• Aged, 80 and over
• Amoxicillin-Potassium Clavulanate Combination (therapeutic use)
• Arthritis, Rheumatoid (drug therapy)
• Azathioprine (adverse effects, therapeutic use)
• Diagnosis, Differential
• Female
• Humans
• Immunocompromised Host
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Prednisone (adverse effects, therapeutic use)