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

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), p.e230287
09/24/2019
DOI: 10.1136/bcr-2019-230287
PMID: 31551318
url
https://www.ncbi.nlm.nih.gov/pmc/articles/6768354View
Open Access

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 Pathological evaluation of the pleura showed sulfur granules and organisms consistent with on Gomori methenamine silver stain; 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 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

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