Mixed Actinomyces israelii and Aggregatibacter actinomycetemcomitans infection causing empyema necessitatis and multiple skin abscesses in an immunocompetent patient

Takaaki Kobayashi; Evgeny Arshava; Bradley Ford; Poorani Sekar

doi:10.1136/bcr-2019-230287

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Mixed Actinomyces israelii and Aggregatibacter actinomycetemcomitans infection causing empyema necessitatis and multiple skin abscesses in an immunocompetent patient

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Mixed Actinomyces israelii and Aggregatibacter actinomycetemcomitans infection causing empyema necessitatis and multiple skin abscesses in an immunocompetent patient

Takaaki Kobayashi, Evgeny Arshava, Bradley Ford and Poorani Sekar

BMJ case reports, Vol.12(9), e230287

09/24/2019

DOI: 10.1136/bcr-2019-230287

PMCID: PMC6768354

PMID: 31551318

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https://pmc.ncbi.nlm.nih.gov/articles/PMC6768354/View

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Abstract

A 45-year-old- man presented with left chest wall pain, swelling and cough. Over a 2-month period he developed abscesses in the right foot, right anterior thigh, left buttock and left chest. Incision and drainage of the soft tissue abscesses and video-assisted thoracoscopic surgery to drain the loculated empyema contiguous with the chest wall abscess were performed as surgical management. Gram stain showed beaded Gram-positive rods and the culture initially grew Aggregatibacter actinomycetemcomitans and Eikenella corrodens. Pathological evaluation of the pleura showed sulfur granules and organisms consistent with Actinomyces spp. on Gomori methenamine silver stain; Actinomyces israelii was recovered in culture with extended incubation. The patient was treated for 3 weeks with ceftriaxone and oral metronidazole, followed by oral amoxicillin. Culture of A. actinomycetemcomitans with other findings consistent with actinomycosis warrants 6–12 months of antibiotic therapy.

Abscess - microbiology

Actinomyces - drug effects

Actinomycosis - drug therapy

Actinomycosis - microbiology

Aggregatibacter actinomycetemcomitans - drug effects

Anti-Bacterial Agents - therapeutic use

Chest Pain

Coinfection - microbiology

Cough

Empyema, Pleural - microbiology

Empyema, Pleural - surgery

Humans

Lung Diseases - microbiology

Male

Middle Aged

Pasteurellaceae Infections - drug therapy

Pasteurellaceae Infections - microbiology

Skin Diseases, Bacterial - drug therapy

Skin Diseases, Bacterial - microbiology

Details

Title: Subtitle: Mixed Actinomyces israelii and Aggregatibacter actinomycetemcomitans infection causing empyema necessitatis and multiple skin abscesses in an immunocompetent patient
Creators: Takaaki Kobayashi - University of Iowa Hospitals and Clinics
Evgeny Arshava - University of Iowa Hospitals and Clinics
Bradley Ford - University of Iowa Hospitals and Clinics
Poorani Sekar - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: BMJ case reports, Vol.12(9), e230287
DOI: 10.1136/bcr-2019-230287
PMID: 31551318
PMCID: PMC6768354
NLM abbreviation: BMJ Case Rep
ISSN: 1757-790X
eISSN: 1757-790X
Language: English
Date published: 09/24/2019
Academic Unit: Infectious Diseases; Pathology; Cardiothoracic Surgery; Internal Medicine
Record Identifier: 9984186502602771

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