We present a case of Actinomyces israelii causing vulvar mass suspicious for malignancy in a postmenopausal woman. A 60 year-old woman presented due to a firm, nonmobile, 10 cm vulvar mass, which had been rapidly enlarging for 5 months. [ncbi.nlm.nih.gov]

• Camping

  A. israelii does not produce catalase, and does not contain CAMP factor, however the bacteria is able to reduce nitrate and hydrolyze urea, as well as ferment arabinose, maltose, sucrose, xylose, and trehalose. [microbewiki.kenyon.edu]

• Developmental Delay

  CASE REPORT A 46-year-old developmentally delayed man presented to an outside hospital in September 2013 with swelling of the left mastoid, bleeding gingiva, and increased oral secretions. [jcm.asm.org]

• Regurgitation

  […] supposed to provide a resistance mechanism to host defenses by inhibiting phagocytosis.2 The most commonly observed clinical features consist of epiphora with discharge (85-94%), pouting punctum (72-75%), conjunctivitis, eyelid matting, and punctual regurgitation [scielo.br]

• Salpingitis

  Abstract Actinomyces israelii was identified in samples from the oviducts of 4/100 women with salpingitis diagnosed by laparoscopy. All four cases healed on 'routine' treatment. [ncbi.nlm.nih.gov]

  Doxycycline in combination with penicillin has been used successfully in the therapy for muscular actinomycosis in an alcoholic patient and in women with salpingitis ( 15, 67 ). [antimicrobe.org]

• Guillain-Barré Syndrome

  CASE REPORT A 43-year-old female, an active intravenous drug user with avascular necrosis of the head of the femur as a consequence of steroid use for treatment of Guillain-Barré syndrome, was treated with a total right hip arthroplasty at the age of [jcm.asm.org]

Workup revealed the presence of a pericardial effusion and pericarditis. Pericardial fluid analysis demonstrated A. israelii. An examination and discussion of the literature is performed regarding this rare manifestation of human actinomycosis. [ncbi.nlm.nih.gov]

Because of the possibility of spinal cord compression and injury, the patient was admitted to the medical intensive care unit for further workup and management. [jcm.asm.org]

• Pericardial Effusion

  Workup revealed the presence of a pericardial effusion and pericarditis. Pericardial fluid analysis demonstrated A. israelii. An examination and discussion of the literature is performed regarding this rare manifestation of human actinomycosis. [ncbi.nlm.nih.gov]

• Nocardia Brasiliensis

  L. acidophilus,L. brevis, L. buchneri, L. casei, L. fermentum, L. gallinarum, L. gasseri) >Nocardia species: 1] Nocardia asteroides 2] Nocardia brasiliensis >Propionibacterium acnes >Rhodococcus equi (formerly Prescottia equi, Corynebacterium equi) Actinomyces [globalrph.com]

  The most common species of Nocardia that cause disease in human beings are N. brasiliensis and N. asteroides. These are soil organisms which can also be found endogenously in the sputum of apparently healthy people. [microbiologybook.org]

• Erysipelothrix Rhusiopathiae

  rhusiopathiae >Listeria monocytogenes >Lactobacillus species (several e.g. [globalrph.com]

• Listeria Monocytogenes

  monocytogenes >Lactobacillus species (several e.g. [globalrph.com]

• Aspergillus Niger

  niger, Fusobacterium species, and Nocardia asteroides.5 Patients usually undergo successful resolution of symptoms following surgery and topical antibiotics.3-5 Ophthalmic conditions reportedly misdiagnosed as lacrimal canaliculitis include mucocele, [scielo.br]

There were no incidents of severe actinomycosis requiring surgery or prolonged hospital treatment although this infection can in rare case be life-threatening. Management of pelvic actinomycosis was discussed. [ncbi.nlm.nih.gov]

Clinical characteristics, treatment patterns, and outcome of primary canaliculitis among patients in Beijing, China. [scielo.br]

Since he has not had any fevers or pain, he had ignored the lumps and had not sought treatment. He states that he has had multiple dental procedures but no other surgeries. [step1.medbullets.com]

[…] risk factors poor oral hygiene dental caries dental extraction or procedure dental trauma intrauterine device (IUD) Pathogenesis anaerobic environment in abscess cavities allow the bacteria to flourish Associated conditions cervicofacial actinomycosis Prognosis [step1.medbullets.com]

Prognosis Actinomycosis is slowly progressive. [merckmanuals.com]

If the actinomycosis is recognized early, cervicofacial infection has an excellent prognosis with the use of antibiotics alone. In the treatment of actinomycosis, tetracyclines are as effective as penicillin. [emedicine.medscape.com]

Etiology Pathogen Actinomyces are primarily anaerobic, gram-positive, non-acid fast, branching, rod-shaped bacteria. Actinomyces bacteria, particularly Actinomyces israelii, are found in the normal oral flora. [amboss.com]

[…] of infection in skin is commonly linked with a traumatic injury, human bite or a perforating injury, which creates an anaerobic environment for Actinomyces israelii to grow in ( J Clin Diagn Res 2014;8:YD03 ) Etiology Caused by Actinomyces israelii in [pathologyoutlines.com]

"Actinomycosis: etiology, clinical features, diagnosis, treatment, and management". Infection and Drug Resistance. 7: 183–197. doi:10.2147/IDR.S39601. PMC 4094581. [en.wikipedia.org]

Actinomycosis: etiology, clinical features, diagnosis, treatment, and management. Infect Drug Resist. 2014;7:183-97. [ Links ] 3 Zhang Q, Xu B, Li XX, Li MW. [scielo.br]

Epidemiology References:[1] Epidemiological data refers to the US, unless otherwise specified. Etiology Pathogen Actinomyces are primarily anaerobic, gram-positive, non-acid fast, branching, rod-shaped bacteria. [amboss.com]

Introduction Classification Actinomyces israelii an anaerobic, branching, filamentous gram + rod produces yellow, sulfur-colored granules transmission direct contact with bacteria Epidemiology demographics male > female location most commonly affects [step1.medbullets.com]

Epidemiology and Pathology These pathogenic, grain-forming, filamentous bacilli are anaerobic and are normal human flora. They frequently colonize the surface and spaces around teeth and the tonsillar crypts. [isradiology.org]

[…] and pathogenesis No data are available on the epidemiology of extrafacial bone and joint actinomycosis. [ncbi.nlm.nih.gov]

Epidemiology [ 1 ] Actinomycosis is rare. [patient.info]

[…] infection from the uterus, associated with intra-uterine contraceptive devices → pelvic actinomycosis History of aspiration, recent oral infection, or ongoing pulmonary malignancy (see aspiration pneumonia) → thoracic actinomycosis References:[1][2][3] Pathophysiology [amboss.com]

[…] anaerobic environment), pelvic (post intrauterine device placement), abdominal (status post ruptured appendix or bowel perforation), and pulmonary (smokers with poor dental hygiene, aspiration of infective material) ( Infect Drug Resist 2014;7:183 ) Pathophysiology [pathologyoutlines.com]

Pathophysiology Canaliculitis is caused by infection of the canaliculus. Although most often caused by a bacterial pathogen, it may also result from fungal or viral infection. [eyewiki.aao.org]

It is primarily a commensal microbe found in normal oral cavities, in tonsillar crypts, in dental plaques, and in carious teeth. [3, 4, 5, 6] Pathophysiology Keratitis Most reported cases of Actinomyces keratitis (keratoactinomycosis) are caused by A [emedicine.medscape.com]

In the case presented herein, therapy with clindamycin failed to halt worsening necrotizing pneumonia or to prevent hematogenous dissemination. [ncbi.nlm.nih.gov]

Sellers, Public Health Image Library, Centers for Disease Control and Prevention.) [accessmedicine.mhmedical.com]

Prevention The best prevention is to maintain good dental hygiene.BiopsyThe process that removes a sample of tissue for microscopic examination to aid in the diagnosis of a disease. [medics-health.blogspot.com]