Associated Actinomycosis and Rhinopharyngeal

Total Page:16

File Type:pdf, Size:1020Kb

Associated Actinomycosis and Rhinopharyngeal Le Infezioni in Medicina, n. 3, 164-172, 2008 Casi clinici Associated actinomycosis and rhinopharyngeal Case reports adenocarcinoma during HIV infection: diagnostic and therapeutic issues Associazione patologica tra actinomicosi ed adenocarcinoma del rinofaringe in corso di infezione da HIV. Aspetti diagnostici e terapeutici Sergio Sabbatani1, Ciro Fulgaro1, Gino Latini2, Marcellino Burzi3, Roberto Manfredi1 1Department of Infectious Diseases, “Alma Mater Studiorum” University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy; 2Department of Otolaryngology, Maggiore General Hospital, Bologna, Italy; 3Department of Radiology, Maggiore General Hospital, Bologna, Italy ■ INTRODUCTION years, after the availability of cART [1-5]. The d- ifferential diagnosis and therefore the treatment hanks to the introduction of potent regi- of these disorders are usually delayed and ham- mens of combined antiretroviral therapy pered by co-existing disorders, especially chron- T(cART), since mid-1996 the frequency of op- ic-relapsing infectious complications, related or portunistic infections had a dramatic decline a- unrelated to the eventual, underlying HIV-asso- mong HIV-infected patients, and the life ex- ciated immunodeficiency [1-5]. pectancy of this patient population significantly In particular, among neoplastic complications increased. At the same time, due to the increased of the ear, nose, and throat (ENT) districts, mean age of HIV-infected population, and a se- those affecting the nose and the rhinopharynx ries of potential supporting factors (i.e. persist- remain somewhat rare among HIV-infected pa- ing immune system imbalance, exposure to tients, with extranodal lymphomas burdened drugs and carcinogenic substances, continued la- by a series of possible local complications, pre- tency of potentially oncogenic viruses, HIV in- vailing over squamous adenocarcinoma and fection itself), haematological and especially sol- other solid tumours, differently from the dis- id organ malignancies showed a proportional in- ease distribution found in the general popula- crease during time. As a consequence, besides tion [6-8]. the traditionally reknown AIDS-related cancers The diagnosis of tumour-like rhinopharyngeal (i.e. Kaposi’s sarcoma, non-Hodgkin’s lym- lesions remains difficult when an expected lym- phoma, and primary central nervous system lym- phocyte-monocyte hyperplasia involving the phoma, together with cervical cancer added to local lymphoid districts occurs in HIV-infected the list since the year 1993), there is a worldwide subjects, who are prone to show a reactive lym- emergence of broad-spectrum haematological phoid proliferation descending from HIV dis- and especially solid organ neoplasms, which al- ease itself, and eventual concurrent infections, so seem to occur at a younger age, and encom- like that caused by Epstein-Barr virus [6-8]. pass a greater aggressivity and a more frequent Moreover, slowly progressive infections possi- and more rapid mortality compared with the bly caused by a large spectrum of pathogenic general population [1-3]. The possible occurrence microorganisms (especially atypical mycobac- of multiple (concurrent or subsequent) malig- teria, and Mycobacterium tuberculosis), may oc- nancies, has been also reported during recent cur as space-occupying masses of the nose 164 2008 and/or the rhinopharynx [9]. They tend to ■ CASE REPORT mimick other local complications, including neoplastic ones, and remarkably complicate the A 49-year-old male ex-i.v. drug user was diag- differential diagnostic process of these lesions. nosed with HIV infection since 13 years, while Finally, similarly to the occurrence of tobacco a concurrent chronic HCV hepatitis was dis- smoking as a known risk factor of upper closed since 10 years. Due to a very low com- aerodigestive tract malignancies, also a pro- pliance to clinical and laboratory controls, both longed exposure to recreational substances (in- antiretroviral therapy and chemoprophylaxis cluding inhalation of drugs like cocaine and against the most common HIV-associated op- heroin), has been described as a possible sup- portunistic infections were denied by our pa- porting factor of rare, anecdotal cases of het- tient during his first three years of follow-up, erogeneous tumours of the nasal cavity among when active drug addiction was still present. HIV-infected subjects, with or without local su- Ten years ago, our patient was hospitalized ow- perinfections caused by the coexistence of ul- ing to the development of an AIDS-defining ill- cerative mucosal lesions, and a varied resident ness (neurotoxoplasmosis). At that time, he ex- flora colonizing the upper respiratory tract [10- perienced his nadir of absolute CD4+ lympho- 12]. With regard to the lesions of the nasal sep- cyte count (36 cells/µL only). tum and nasal cartilage and sinusal bone tis- After successful cure of this central nervous sue, when excluding congenital lesions, all ac- system opportunistic complication, our patient quired ones usually show aspecific imaging finally accepted a combined antiretroviral ther- findings also at sophisticated study techniques, apy (cART), initially conducted with didano- like X-ray films, computerized tomography sine, stavudine, and indinavir, together with a (CT) scans, magnetic resonance imaging (MRI), secondary prophylaxis for toxoplasmosis, car- and so on. ried out with cotrimoxazole, in order to prevent These lesions may be caused by a very broad a pneumocystosis, too. Despite a limited adher- spectrum of causes, including nasal trauma (in- ence to antiretroviral therapy (not exceeding volving surgical interventions and invasive di- 70-80% of recommended doses, as assessed on agnostic procedures, accidents, but also the ground of spontaneous patient’s declara- rhinotillexomania), exposure to toxic sub- tions, and monthly drug accountability carried stances (including local decongestants and in- out at our dedicated HIV outpatient service), a haled cocaine or other drugs), inflammatory progressive recovery of the CD4+ count at lev- diseases (i.e. sarcoidosis, reparative granulo- els above 200 cells/µL, allowed the discontinu- mas, Wegener’s granulomatosis, and other col- ation of cotrimoxazole prophylaxis eight lagen vascular diseases), multiple infection months after hospital discharge. Even though a (caused by bacteria, mycobacteria, fungi, or as- complete suppression of HIV viremia was sociated microorganisms), or malignancies reached after the first six months of cART, it (whose large spectrum of disorders includes was never sustained subsequently, probably carcinomas, sarcoma, Pindborg tumor, angiofi- due to the limited patient’s adherence to differ- broma, hemangioma, neuroendocrine tumor, ent, alternative regimens of cART proposed in schwannoma, and primary or secondary le- order to enhance his adherence. During the sions of lymphoproliferative disorders) [12]. subsequent laboratory follow-up, plasma HIV- Aim of our present report is to describe an ex- RNA levels ranging from 450 and 4,300 tremely rare occurrence of associated rhinopha- copies/mL were disclosed, in absence of fur- ryngeal actinomycosis and squamous adeno- ther occurrences of negative viremia. carcinoma in a HIV-infected patients treated During the further follow-up until recently, our with cART and with some specific and local patient progressively abandoned i.v. drug ad- risk factors (cigarette smoking, long-term in- diction but resorted to a “recreational”, inhala- halatory substance abuse, and a half-profes- tory use of both cocaine and heroin. Moreover, sional mushroom-truffle search and evaluation he continued a personal semi-professional hob- by smell). by regarding frequent mushroom and truffle The histopathological and imaging diagnostic search, and continued tobacco (cigarette) smok- work-up of our patient’s disease, and its thera- ing, which lasted since the age of 16 years. peutic and outcome features, are presented and Despite low adherence levels to four different discussed on the ground of the available litera- lines of cART, the stable and sufficiently satis- ture evidences. factory immune recovery, as established by a 165 2008 CD4+ count always above 400 cells/µL (above systemic broad-spectrum antibiotic treatment, 26-30% of total T-lymphocytes, with a peak val- associated with non-steroideal anti-inflamma- ue of 486 cells/µL in the year 2003), and the tory drugs and mucolytics. After repeated ENT negligible clinical history, allowed our patient specialistic consultations, our patient under- to maintain his low-adherence cART regimen, went a contrast-enhanced CT scan and MRI of until a genotypic resistance testing of 12 the face and brain, which pointed out an ag- months ago performed with rising plasma HIV- gressive form of rhinitis and sinusitis, with a se- RNA levels (5,190 copies/mL). This last viro- vere inflammatory involvement of maxillary logical assay detected multiple nucleo- and ethmoidal sinuses (Figures 1 and 2). side/nucleotide resistance mutations, complete Subsequently, a fiberoptic rhinoscopy (Figure resistance to both available non-nucleoside re- 3) with associated multiple biopsies, culture, verse transcriptase inhibitors, and multiple pro- and histopathological examination, disclosed a tease inhibitors resistance mutations, so that a predominantly necrotic tissue with abundant cART regimen including lamivudine, abacavir, fibrin deposition, and actinomycosis-like “sul- and fosamprenavir-ritonavir was introduced phur” granules surrounded by a relevant
Recommended publications
  • WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2014/134709 Al 12 September 2014 (12.09.2014) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/05 (2006.01) A61P 31/02 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, (21) International Application Number: BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, PCT/CA20 14/000 174 DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR, 4 March 2014 (04.03.2014) KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, (25) Filing Language: English OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, (26) Publication Language: English SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, (30) Priority Data: ZW. 13/790,91 1 8 March 2013 (08.03.2013) US (84) Designated States (unless otherwise indicated, for every (71) Applicant: LABORATOIRE M2 [CA/CA]; 4005-A, rue kind of regional protection available): ARIPO (BW, GH, de la Garlock, Sherbrooke, Quebec J1L 1W9 (CA). GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, (72) Inventors: LEMIRE, Gaetan; 6505, rue de la fougere, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, Sherbrooke, Quebec JIN 3W3 (CA).
    [Show full text]
  • Applied Microbiology August 18-20, 2015 Frankfurt, Germany
    Chit Laa Poh, J Microb Biochem Technol 2015, 5:4 http://dx.doi.org/10.4172/1948-5948.S1.013 World Congress and Expo on Applied Microbiology August 18-20, 2015 Frankfurt, Germany Enterovirus 71: Candidates for vaccines and antivirals Chit Laa Poh Sunway University, Malaysia and, foot and mouth disease (HFMD) is commonly caused by a group of Enteroviruses such as Enterovirus 71(EV71) Hand Coxsackievirus CVA5, CVA8 and CVA 16. Coxsackieviruses generally cause mild symptoms such as high fever, rashes and vesicles in the hand, foot and mouth but EV71 can produce more severe symptoms such as brainstem encephalitis, leading to cardiopulmonary failure and death. China experienced over 2.7 million cases of HFMD infections with 384 deaths in 2014. The lack of vaccines and antiviral drugs against EV71 highlights the urgency of developing preventative and treatment agents against EV71 to prevent further fatalities. The inactivated vaccine (IV) is well advanced in development and has good clinical trial data to support the use of the vaccine. It is ready for production in China but it remains to be investigated if the immunogenicity of the IV is able to confer protection against all EV71 sub-genotypes. Although there is data to support broad protection for some genotypes/sub-genotypes at varying efficacies, more studies need to be carried out on whether the neutralizing levels induced by IV are sufficient to protect against serious HFMD infections. New developments of experimental vaccines and antivirals are presented. Biography Chit Laa Poh completed her PhD from Monash University, Australia in 1980 and returned to Malaysia and Singapore to pursue her academic career.
    [Show full text]
  • Primary Cutaneous Actinomycosis
    Letters to the Editor 327 Primary Cutaneous Actinomycosis Sir, Actinomycosis is a chronic progressive suppurative and granu- lomatous disease caused by Actinomyces israelii. It can a¡ect all organs and tissues of the body, however, primary cutaneous actinomycosis is rare (1). The lesions occur as subcutaneous nodules, usually on the exposed areas, which enlarge slowly and ulcerate to form sinuses. The disease continues for several years, causing marked ¢brosis in the a¡ected area. We report here a patient with primary cutaneous actinomy- cosis occurring in an unexposed area, who was treated with penicillin. CASE REPORT A 17-year-old girl presented with a 12-year history of painful, erythe- matous nodules, discharging sinuses and scars with di¡use ¢rm swel- lings on both buttocks extending up to the lower back. The lesions had started on the left buttock in a localized area 4 ^ 5 months after some intramuscular injections. They were appearing as erythematous nodules, which used to ulcerate in 3 ^ 4 weeks to discharge seropurulent material and heal after a variable period with puckered scars. Some of the lesions were forming puckered sinus tracts with intermittent sero- purulent discharge. She also had a history of intermittent low-grade fever and malaise. There was no history of discharging granules or bony pieces from the lesions. She had no other symptoms. Cutaneous examination revealed a ¢rm, di¡use, tender, subcuta- neous swelling with multiple erythematous, soft, £uctuant, tender, dis- crete and grouped papules and nodules involving both buttocks, natal cleft and the lower back (F|g. 1). Some of the papules and nodules had ulcerated in the centre with seropurulent discharge, some had healed with puckered scars while others had formed puckered sinus tracts dis- charging seropurulent material on pressure.
    [Show full text]
  • A Histopathological Study of Granulo- Matous Inflammationswith an Attempt Pathology Section to Find the Aetiology
    ORIGINAL ARTICLE A Histopathological study of Granulo- matous Inflammationswith an attempt Pathology Section to find the Aetiology JAYASHREE PAWALE, REKHA PURANIK, MH KULKARNI ABSTRACT Granulomas are the commonest lesions that the pathologists fungal infections and foreign body granulomas and granulomas come across in routine practice. In order to treat these lesions, with unknown aetiology. definitive diagnosis by the demonstration of the aetiological agent is essential, which will bear an impact on the patient man- An attempt has to be made to put these granulomas into specific agement and outcome. aetiological categories for specific treatment. Our aim was to find the aetiology in all the granulomatous le- The morphology of the lesions and the use of special stains sions, on histopathologically evaluated biopsies. helped us to diagnose 159 out of the 170 cases. A two year prospective study was done in KIMS; Hubli.The bi- KEY MESSAGE opsies of the cases which were diagnosed as granulomas on H 1. Granulomas are the commonest lesions that the patholog- and E stained sections from all the sites were selected. Special ists come across in routine practice. stains like Ziehl-Neelsen stain, Gomori’s Methenamine silver, 2. Tuberculosis is the commonest cause of granuloma. Fite Faraco and Auramine Rhodamine stain were done wherever 3. The morphology of the lesions and special stains helped us required. to identify the aetiology. A total of 170 granulomatous lesions were studied. Granulomas with different aetiologies were seen. The commonest were the granulomas due to tuberculosis with 84 (49.41%) cases, fol- lowed by those with leprosy, rhinoscleroma, actinomycosis and Key Words: Granulomas, Tuberculosis, Fungal INTRODUCTION The term, ‘Granulomatous inflammation’ defines a pattern of reac- Classification based on the morphological criteria: tion to a wide range of aetiological agents, organic and inorganic, 1.
    [Show full text]
  • Fibroblast Growth Factor 23 and the Risk of Infection-Related Hospitalization in Older Adults
    CLINICAL EPIDEMIOLOGY www.jasn.org Fibroblast Growth Factor 23 and the Risk of Infection-Related Hospitalization in Older Adults † ‡ Kristen L. Nowak,* Traci M. Bartz, Lorien Dalrymple, Ian H. de Boer,§ Bryan Kestenbaum,§ | †† ‡‡ || Michael G. Shlipak, ¶** Pranav S. Garimella, Joachim H. Ix, §§ and Michel Chonchol* *Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado; †Department of Biostatistics and §Division of Nephrology and Kidney Research Institute, University of Washington, Seattle, Washington; ‡Department of Medicine, University of California, Davis, Sacramento, California; Departments of |Medicine and ¶Epidemiology and Biostatistics, University of California, San Francisco, California; **General Internal Medicine Section, San Francisco Veterans Affairs Medical Center, San Francisco, California; ††Division of Nephrology, Tufts Medical Center, Boston, Massachusetts; Divisions of ‡‡Nephrology and §§Preventative Medicine, University of California, San Diego, California; and ||Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California ABSTRACT Within monocytes, 1,25-dihydroxyvitamin D [1,25(OH)2D] is important for production of cathelicidins, which in turn, are critical for antibacterial action. Fibroblast growth factor 23 (FGF23) decreases 1,25(OH)2D production and thus, could increase infection risk. We examined this possibility in 3141 community-dwelling adults ages $65 years old at baseline in the Cardiovascular Health Study using Cox proportional hazards models to ex- amine the association between FGF23 concentrations and first infection-related hospitalizations and determine whether associations differed by the presence of CKD (eGFR,60 ml/min per 1.73 m2 [n=832] or urine albumin- to-creatinine ratio .30 mg/g [n=577]). Mean6SD age of participants was 7865 years old, 60% of participants were women, and the median plasma FGF23 concentration was 70 (interquartile range, 53–99) relative units per milliliter.
    [Show full text]
  • Indian Journal of Medical Microbiology Vol
    October-December 2007 INDIAN JOURNAL OF 451 MEDICAL MICROBIOLOGY (OfÞ cial publication of Indian Association of Medical Microbiologists, Published quarterly in January, April, July and October) Indexed in Index Medicus/MEDLINE/PubMed, ‘Elsevier Science - EMBASE’, ‘IndMED’ EDITORIAL BOARD EDITOR Dr. SAVITRI SHARMA L V Prasad Eye Institute Bhubaneswar - 751 024, India ASSOCIATE EDITOR ASSISTANT EDITOR Dr. Shobha Broor Dr. V Lakshmi Professor, Department of Microbiology Professor and Head, Dept. of Microbiology All India Institute of Medical Sciences Nizam’s Institute of Medical Sciences New Delhi - 110 029, India Punjagutta, Hyderabad - 500 082, India ASSISTANT EDITOR ASSISTANT EDITOR Dr. P Sugandhi Rao Dr. Reba Kanungo Professor Professor and Head Department of Microbiology Department of Microbiology, Perunthalaivar Kamaraj Kasturba Medical College Medical College and Research Institute, Kadhirkamam, Manipal - 576 119, India Puducherry - 605 009, India MEMBERS National International Dr. Arora DR (Rohtak) Dr. Arseculeratne SN (Srilanka) Dr. Arunaloke Chakrabarthi (Chandigarh) Dr. Arvind A Padhye (USA) Dr. Camilla Rodrigues (Mumbai) Dr. Chinnaswamy Jagannath (USA) Dr. Chaturvedi UC (Lucknow) Dr. Christian L Coles (USA) Dr. Hemashettar BM (Belgaum) Dr. David WG Brown (UK) Dr. Katoch VM (Agra) Dr. Diane G Schwartz (USA) Dr. Madhavan HN (Chennai) Dr. Govinda S Visveswara (USA) Dr. Mahajan RC (Chandigarh) Dr. Kailash C Chadha (USA) Dr. Mary Jesudasan (Thrissur) Dr. Madhavan Nair P (USA) Dr. Meenakshi Mathur (Mumbai) Dr. Madhukar Pai (Canada) Dr. Nancy Malla (Chandigarh) Dr. Mohan Sopori (USA) Dr. Philip A Thomas (Tiruchirapally) Dr. Paul R Klatser (Netherlands) Dr. Ragini Macaden (Bangalore) Dr. Vishwanath P Kurup (USA) Dr. Ramesh K Aggarwal (Hyderabad) Dr. Renu Bhardwaj (Pune) Dr.
    [Show full text]
  • Primary Cutaneous Actinomycosis of the Femorogluteal Region: Two Case Reports
    Letters to the Editor 445 Primary Cutaneous Actinomycosis of the Femorogluteal Region: Two Case Reports Rita Varga, Alexander Kovneristy, Matthias Volkenandt, Miklós Sárdy and Thomas Ruzicka Department of Dermatology and Allergology, Ludwig-Maximilian University, DE-80337 Munich, Germany. E-mail: [email protected] Accepted October 18, 2011. Actinomycosis is a rare, chronic infection characterized graphy (CT) showed no relevant abnormalities. Intravenous by induration, multiple abscesses and draining sinuses (1). treatment with benzylpenicillin (24 million units/day) was star- ted in combination with oral trimethoprim+sulphamethoxazole Cervicofacial actinomycosis is the most common form, (320+1,600 mg/day) for 6 weeks, followed by amoxicillin which is usually caused by deep oral mucosal injury. The (2 g/day) orally for 3 months. Five months later, a decrease in major pathogen is Actinomyces israelii, a commensal of the number and extent of ulcerations, induration and nodules the oropharyngeal flora (2). Actinomycosis of the lower was detected, and the exudate disappeared (Fig. 1B). part of the body, especially the primary cutaneous form, Case 2. A 69-year-old man without comorbidities had a one- is very unusual (3–5). A. turicensis is a recently identified year history of indurations, ulcerations and nodules in the right femorogluteal region, with fistulas, foetid secretion, and distinct Actinomycetes species (6) found particularly in enlarged regional lymph nodes (Fig. 2A). infections of the lower part of the body, especially in the Routine laboratory blood examinations and urinalysis were anorectal and urogenital regions (3, 7). normal, except for highly elevated C-reactive protein levels (15.2 mg/dl; normal < 0.50 mg/dl) and lymphopaenia (13.0%; normal 25.0–40.0%) with a total lymphocyte count of 1,170/µl.
    [Show full text]
  • Conference 4 30 September 2009
    The Armed Forces Institute of Pathology Department of Veterinary Pathology Conference Coordinator: Shannon Lacy, DVM, MPH WEDNESDAY SLIDE CONFERENCE 2009-2010 Conference 4 30 September 2009 Conference Moderator: Taylor B. Chance, DVM, Diplomate ACVP Contributor’s Morphologic Diagnosis: Skin: CASE I: Case II (AFIP 2936428). Dermatitis, moderate, eosinophilic granulomatous with collagenolysis and mineralization, Quarter Horse (Equus caballus), equine. Signalment: 7-year-old gelding quarter horse (Equus caballus). Contributor’s Comment: This lesion, frequently encountered in skin biopsies from asymptomatic horses, History: Examined by a local veterinarian for skin is known as nodular necrobiosis, nodular collagenolytic lesions on the back, which were then biopsied. granuloma, acute collagen necrosis, or eosinophilic granuloma.5 There is no apparent breed, age, or sex Gross Pathology: Firm mass present on the back of the predisposition for this disease.4,5 The etiology of this saddle region of horse. lesion is unknown, but a hypersensitivity reaction to an arthropod injury is suspected because the lesion Histopathologic Description: Microscopically, occurs more commonly in warmer months.5,7 Due to collagen degeneration with multifocal regions of lesions commonly occurring in the saddle region, it also dystrophic mineralization is observed in regions of has been suggested that trauma may be a contributing the deep dermis with degranulating and degenerative factor.4,5 Furthermore, atopy has been suggested as a eosinophils (fig. 1-1). Superficial and deep perivascular predisposing factor based on positive skin test results in dermatitis with marked eosinophilia and smaller numbers a horse with collagenolytic granulomas.4 More than one of macrophages, lymphocytes and plasma cells are noted causal agent is likely responsible for a seemingly identical (fig.
    [Show full text]
  • Primary Cutaneous Actinomycosis Anjum Kanjee Jinnah Postgraduate Medical Centre
    eCommons@AKU Department of Pathology and Laboratory Medicine Medical College, Pakistan November 1998 Primary Cutaneous Actinomycosis Anjum Kanjee Jinnah Postgraduate Medical Centre Zamaz Wahid Civil Hospital Karachi Shahid Pervez Aga Khan University, [email protected] Follow this and additional works at: http://ecommons.aku.edu/ pakistan_fhs_mc_pathol_microbiol Part of the Bacterial Infections and Mycoses Commons, and the Pathology Commons Recommended Citation Kanjee, A., Wahid, Z., Pervez, S. (1998). Primary Cutaneous Actinomycosis. Journal of Pakistan Medical Association, 48(11), 347-349. Available at: http://ecommons.aku.edu/pakistan_fhs_mc_pathol_microbiol/299 Primary Cutaneous Actinomycosis Pages with reference to book, From 347 To 349 Anjum Kanjee ( Department of Pathology, Jinnah Postgraduate Medical Centre, Karachi. ) Zamaz Wahid ( Department of Dermatology,Civil Hospital, Karachi. ) Shahid Pervez ( Department of Pathology, Aga Khan University Hospital, Karachi. ) Actinomycosis is a chronic granulomatous disease caused mainly by Actinomyces israelii. It is characterized by formation of multiple draining sinuses with discharge of characteristic yellow sulphur granules. There am five clinical types depending on the primary site of infection, namely cervicofacial, thoracic,, abdominal, primary cutaneous and pelvic. Primary cutaneous actinomycosis is very uncommon. A case of primaiy cutaneous actinomycosis is reported here. Case Report A forty year old farmer presented with multiple nodules and discharging sinuses on lower abdomen, buttocks, scrotal and penile skin (Figures 1 and 2). These lesions had gradually appeared over a period of 10 years. The regional lymph nodes were notenlarged. General physical and systemic examination was unremarkable. Preliminary investigations showed normal X-ray chest, ahaemoglobinlevel of 14.2 G%, ThC 8,200/mm 3 and ESR of 79 mm infirst hour.
    [Show full text]
  • Biology and Biotechnology of Actinobacteria Biology and Biotechnology of Actinobacteria Joachim Wink Fatemeh Mohammadipanah Javad Hamedi Editors
    Joachim Wink Fatemeh Mohammadipanah Javad Hamedi Editors Biology and Biotechnology of Actinobacteria Biology and Biotechnology of Actinobacteria Joachim Wink Fatemeh Mohammadipanah Javad Hamedi Editors Biology and Biotechnology of Actinobacteria Editors Joachim Wink Fatemeh Mohammadipanah Microbial Strain Collection; College of Science Helmholtz- Centre for Infection Research University of Tehran Braunschweig Tehran Germany Iran Javad Hamedi College of Science University of Tehran Tehran Iran ISBN 978-3-319-60338-4 ISBN 978-3-319-60339-1 (eBook) DOI 10.1007/978-3-319-60339-1 Library of Congress Control Number: 2017955832 © Springer International Publishing AG 2017 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made.
    [Show full text]
  • IJMM Oct 07.Indd
    October-December 2007 INDIAN JOURNAL OF 451 MEDICAL MICROBIOLOGY (OfÞ cial publication of Indian Association of Medical Microbiologists, Published quarterly in January, April, July and October) Indexed in Index Medicus/MEDLINE/PubMed, ‘Elsevier Science - EMBASE’, ‘IndMED’ EDITORIAL BOARD EDITOR Dr. SAVITRI SHARMA L V Prasad Eye Institute Bhubaneswar - 751 024, India ASSOCIATE EDITOR ASSISTANT EDITOR Dr. Shobha Broor Dr. V Lakshmi Professor, Department of Microbiology Professor and Head, Dept. of Microbiology All India Institute of Medical Sciences Nizam’s Institute of Medical Sciences New Delhi - 110 029, India Punjagutta, Hyderabad - 500 082, India ASSISTANT EDITOR ASSISTANT EDITOR Dr. P Sugandhi Rao Dr. Reba Kanungo Professor Professor and Head Department of Microbiology Department of Microbiology, Perunthalaivar Kamaraj Kasturba Medical College Medical College and Research Institute, Kadhirkamam, Manipal - 576 119, India Puducherry - 605 009, India MEMBERS National International Dr. Arora DR (Rohtak) Dr. Arseculeratne SN (Srilanka) Dr. Arunaloke Chakrabarthi (Chandigarh) Dr. Arvind A Padhye (USA) Dr. Camilla Rodrigues (Mumbai) Dr. Chinnaswamy Jagannath (USA) Dr. Chaturvedi UC (Lucknow) Dr. Christian L Coles (USA) Dr. Hemashettar BM (Belgaum) Dr. David WG Brown (UK) Dr. Katoch VM (Agra) Dr. Diane G Schwartz (USA) Dr. Madhavan HN (Chennai) Dr. Govinda S Visveswara (USA) Dr. Mahajan RC (Chandigarh) Dr. Kailash C Chadha (USA) Dr. Mary Jesudasan (Thrissur) Dr. Madhavan Nair P (USA) Dr. Meenakshi Mathur (Mumbai) Dr. Madhukar Pai (Canada) Dr. Nancy Malla (Chandigarh) Dr. Mohan Sopori (USA) Dr. Philip A Thomas (Tiruchirapally) Dr. Paul R Klatser (Netherlands) Dr. Ragini Macaden (Bangalore) Dr. Vishwanath P Kurup (USA) Dr. Ramesh K Aggarwal (Hyderabad) Dr. Renu Bhardwaj (Pune) Dr.
    [Show full text]
  • Actinomycosis in Histopathology - Review of Literature
    L. Veenakumari, C. Sridevi. Actinomycosis in histopathology - Review of literature. IAIM, 2017; 4(9): 195-206. Review Article Actinomycosis in histopathology - Review of literature L. Veenakumari1*, C. Sridevi2 1Professor, 2Assistant Professor Department of Pathology, Mallareddy Medical College for Women, Suraram, Quthbullapur, Hyderabad, Telangana, India *Corresponding author email:[email protected] International Archives of Integrated Medicine, Vol. 4, Issue 9, September, 2017. Copy right © 2017, IAIM, All Rights Reserved. Available online athttp://iaimjournal.com/ ISSN: 2394-0026 (P)ISSN: 2394-0034 (O) Received on: 22-08-2017 Accepted on:28-08-2017 Source of support: Nil Conflict of interest: None declared. How to cite this article: L. Veenakumari, C. Sridevi. Actinomycosis in histopathology - Review of literature. IAIM, 2017; 4(9): 195-206. Abstract Actinomycosis is a chronic, suppurative granulomatous inflammation caused by Actinomyces israelli which is a gram positive organism that is a normal commensal in humans. Multiple clinical features of actinomycosis have been described, as various anatomical sites can be affected. It most commonly affects the head and neck (50%). In any site, actinomycosis frequently mimics malignancy, tuberculosis or nocardiosis. Physicians must be aware of clinical presentations but also that actinomycosis mimicking malignancy. In most cases, diagnosis is often possible after surgical exploration. Following the confirmation of diagnosis, antimicrobial therapy with high doses of Penicillin G or Amoxicillin is required. This article is intended to review the clinical presentations, histopathology and complications of actinomycosis in various sites of the body. Key words Actinomycosis, Actinomyces, Sulphur granules, Histopathology, Filamentous bacteria. Introduction Actinomyces is a filamentous gram positive Actinomyces,”ray fungus” (Greek actin-ray, bacteria of genus Actinobacteria.
    [Show full text]