Actinomycosis with pericardio-pleural effusion and ascites. A Rare presentation
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Abstract:
Background- Actinomycosis is an uncommon disease caused by Actinomyces spp., Gram-positive, anaerobic or microaerobic
bacteria that normally colonize the human mouth and GIT and genital tracts. Cardio-pulmonary
actinomycosis with peritoneal involvement is a rare presentation.
Case report – A 29 years old female normotensive
and euglycemic, smoker with poor oral hygiene was referred to us an outside hospital
with complaints of right lower chest pain with severe shortness of breath and low
grade fever last 4 hrs . On examination she showed dental caries, right chest bulging
with diminished breath sounds, distended abdomen, raised WBC counts and normal ECG,
Chest X-Ray showed right sided pleural effusion and bilateral opacities, pericardial
effusion and ascites which were confirmed by 2D echo, CT chest & abdomen . Lab
tests were negative for tuberculosis or malignancy. Finally she was diagnosed as
an actinomycosis israelii based on culture and biopsy. She was treated with long
course of appropriate antibiotics and fluid drainage.
Conclusion-Patients with actinomycosis
require prolonged high doses of penicillin G or amoxicillin and other sensitive
antibiotics and drainage. Early diagnosis will reduce the hospital stay or mortality
in such kind of patients.
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