Actinomyces funkei bacteraemia and infected pulmonary cavities in an intravenous drug user: a case report.

IF 3.6 Q1 TROPICAL MEDICINE
Tanaraj Perinpanathan, Katherine Beckett, Chris Smith
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引用次数: 0

Abstract

Background: Actinomyces spp. are most commonly found in human commensal flora; however, they have also been shown to cause suppurative infections. We present a case of a rare Actinomyces funkei bacteraemia from an infected deep vein thrombosis in a patient who went on to develop pulmonary cavities secondary to septic emboli. Infected thrombi and septic emboli have been associated with other Actinomyces spp. in the literature, often posing a diagnostic challenge and, in some cases, causing drastic clinical deterioration in patients. The literature regarding Actinomyces funkei is scarce and to our knowledge there are no reports of a relationship between this Actinomyces subspecies and infected thrombi or septic emboli.

Case presentation: The patient was a 39-year-old known intravenous drug user who presented with a groin injecting site sinus and systemic symptoms. The bacteria was first observed by gram staining of a blood culture sample after 48 h of incubation and the species was identified using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) as Actinomyces funkei. Sputum cytology/histology with cell block revealed a branching gram-positive species suspicious of slow growing bacteria or fungus. CT imaging of his lower limb and chest revealed an extensive DVT with inflammatory changes and pulmonary cavities respectively. The patient was treated with Ceftriaxone before being discharged with a 6-month course of Linezolid. He made a good recovery with reduction in size of the cavitating lung lesions on follow-up imaging.

Conclusions: This case report presents a difficult-to-diagnose bacterial infection in an intravenous drug user, complicated by bacteraemia and secondary septic emboli. Relatively little is known about Actinomyces funkei, and therefore this report aims to increase clinician awareness of diagnosis, management, and complications.

一名静脉注射吸毒者的放线菌菌血症和肺腔感染:病例报告。
背景:放线菌属最常见于人类共生菌群,但也被证明可引起化脓性感染。我们介绍了一例罕见的放线菌菌血症病例,患者因感染深静脉血栓而继发肺腔化脓性栓塞。在文献中,感染性血栓和化脓性栓子与其他放线菌属有关,往往给诊断带来困难,在某些情况下还会导致患者临床症状急剧恶化。有关放线菌的文献很少,据我们所知,还没有关于这种放线菌亚种与感染性血栓或化脓性栓子之间关系的报道:患者是一名 39 岁的已知静脉注射吸毒者,出现腹股沟注射部位窦道和全身症状。培养 48 小时后,通过对血液培养样本进行革兰氏染色首次观察到该细菌,并使用基质辅助激光解吸电离飞行时间(MALDI-TOF)鉴定出其为放线菌。痰细胞学/组织学检查和细胞阻断发现了一种革兰氏阳性分支菌,怀疑是生长缓慢的细菌或真菌。下肢和胸部的 CT 成像显示,深静脉血栓广泛存在,并分别伴有炎症变化和肺空洞。患者接受了头孢曲松治疗,出院前服用了为期 6 个月的利奈唑胺。患者恢复良好,随访造影显示肺部空洞病灶缩小:本病例报告了一名静脉注射吸毒者因细菌感染而导致的难以诊断的并发菌血症和继发性化脓性栓塞。人们对放线菌的了解相对较少,因此本报告旨在提高临床医生对诊断、处理和并发症的认识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
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