Primary Axillary Actinomycosis: A Case Report on the Integration of Culture and Molecular Diagnostics for Accurate Diagnosis of Polymicrobial Infections.

IF 4.1 2区 生物学 Q2 MICROBIOLOGY
Junko Tezuka, Noriyuki Abe, Hiroshi Tanabe
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引用次数: 0

Abstract

Actinomycosis is a chronic suppurative granulomatous disease caused by Actinomyces spp. Although cutaneous actinomycosis is rare, dermatologists must consider it due to its potential coexistence with other pathogens, often as part of polymicrobial infections. We present a rare case of primary axillary cutaneous actinomycosis in a young woman, likely triggered by cosmetic axillary hair removal and home shaving practices. Histological examination revealed characteristics of actinomycosis, including sulfur granules and Gram-positive filamentous structures. Bacterial cultures failed to isolate Actinomyces, but identified Staphylococcus epidermidis, S. aureus (MRSA), and Corynebacterium simulans, suggesting a polymicrobial infection contributing to the inflammatory response. Molecular analysis of DNA extracted from formalin-fixed paraffin-embedded (FFPE) tissue yielded a 675 bp PCR product using Actinomyces-specific primers. BLAST analysis confirmed the species as A. gerencseriae, establishing the diagnosis of actinomycosis. However, a 1000 bp PCR product obtained using universal 16S rDNA primers could not be sequenced successfully, likely due to the presence of multiple bacterial species. Notably, Actinomyces was detected only through molecular methods, while bacterial cultures identified the aforementioned bacteria. This discrepancy between FFPE-PCR results and bacterial culture findings demonstrates a key challenge in the microbiological diagnosis of polymicrobial infections. This case highlights the importance of integrating histopathological, microbiological, and molecular techniques for accurate pathogen identification in polymicrobial infections. The failure to detect Actinomyces in bacterial cultures, despite its presence in FFPE-PCR, suggests that conventional culture methods alone may be insufficient for diagnosing such infections. Extended culture durations, selective anaerobic culture techniques, and molecular diagnostic methods are essential for a comprehensive evaluation. Recognizing Actinomyces as more than a contaminant is important for timely diagnosis and effective treatment. Increased awareness of its potential involvement in polymicrobial infection should improve clinical outcomes.

原发性腋窝放线菌病:结合培养和分子诊断准确诊断多微生物感染1例报告。
放线菌病是一种由放线菌引起的慢性化脓性肉芽肿性疾病,虽然皮肤放线菌病很少见,但由于它可能与其他病原体共存,通常作为多微生物感染的一部分,皮肤科医生必须考虑到它。我们提出一个罕见的病例原发性腋窝皮肤放线菌病在一个年轻的女人,可能是由美容腋毛脱毛和家庭剃须的做法引发的。组织学检查显示放线菌病的特征,包括硫颗粒和革兰氏阳性丝状结构。细菌培养未能分离出放线菌,但鉴定出表皮葡萄球菌、金黄色葡萄球菌(MRSA)和拟棒状杆菌,表明多种微生物感染导致了炎症反应。利用放线菌特异性引物对福尔马林固定石蜡包埋(FFPE)组织中提取的DNA进行分子分析,得到一个675 bp的PCR产物。BLAST分析证实该菌种为A. gerencserae,建立放线菌病诊断。然而,使用通用16S rDNA引物获得的1000 bp PCR产物无法成功测序,可能是由于存在多种细菌物种。值得注意的是,放线菌仅通过分子方法检测,而细菌培养可识别上述细菌。FFPE-PCR结果与细菌培养结果之间的差异表明了多微生物感染的微生物学诊断的关键挑战。这个病例强调了整合组织病理学、微生物学和分子技术在多微生物感染中准确鉴定病原体的重要性。尽管放线菌在FFPE-PCR中存在,但未能在细菌培养物中检测到放线菌,这表明仅靠传统的培养方法可能不足以诊断此类感染。延长培养时间,选择性厌氧培养技术和分子诊断方法是必要的全面评估。认识到放线菌不仅仅是一种污染物,对于及时诊断和有效治疗非常重要。提高对其与多微生物感染的潜在关系的认识应能改善临床结果。
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
Microorganisms
Microorganisms Medicine-Microbiology (medical)
CiteScore
7.40
自引率
6.70%
发文量
2168
审稿时长
20.03 days
期刊介绍: Microorganisms (ISSN 2076-2607) is an international, peer-reviewed open access journal which provides an advanced forum for studies related to prokaryotic and eukaryotic microorganisms, viruses and prions. It publishes reviews, research papers and communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. Electronic files and software regarding the full details of the calculation or experimental procedure, if unable to be published in a normal way, can be deposited as supplementary electronic material.
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