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Review
. 2022 Mar 29;22(1):310.
doi: 10.1186/s12879-022-07282-w.

Disseminated cutaneous Actinomyces bovis infection in an immunocompromised host: case report and review of the literature

Flávia Cunha  1 , David Lopes Sousa  2 , Luís Trindade  3 , Vítor Duque  3   4
Affiliations
Review

Disseminated cutaneous Actinomyces bovis infection in an immunocompromised host: case report and review of the literature

Flávia Cunha et al. BMC Infect Dis. .

Abstract

Background: Actinomycosis is an uncommon endogenous bacterial infection caused by Actinomyces species, characterized by the development of abscesses, tissue fibrosis, and fistulisation. It remains a diagnostic challenge, due to its similarities with diverse aetiologies' presentation, such as neoplasms, tuberculosis, or fungal infections. Actinomyces bovis is a microorganism rarely reported as a cause of human disease. Cutaneous involvement is sporadic. In this case, Actinomyces bovis was responsible for disseminated cutaneous disease in an immunosuppressed patient.

Case presentation: We report the case of a 69-year-old female with multiple skin masses, under immunosuppressive therapy due to ulcerative colitis. Imaging exams were compatible with multiple cutaneous abscesses in the cervicofacial region and limbs. Actinomyces bovis was isolated in culture after abscess drainage. Antimicrobial therapy with parenteral penicillin G and oral amoxicillin was administered for 6 months, with complete resolution of cutaneous lesions and no relapse of the infection.

Conclusions: Considering actinomycosis as a possible diagnosis in the presence of subacute/chronic recurrent mass-like cutaneous lesions, especially in the setting of immunosuppression, may reduce the burden associated with delayed diagnosis and incorrect treatment and provide better outcomes and improvement of patient's quality of life.

Keywords: Actinomyces bovis; Actinomycosis; Case report; Immunosuppression; Ulcerous colitis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Cervical lesions with drainage of purulent material
Fig. 2
Fig. 2
Forehead lesions with presence of yellowish grains
Fig. 3
Fig. 3
Knee abscess with loss of deep tissue integrity
Fig. 4
Fig. 4
Cervical lesion observed on cervical CT scan
Fig. 5
Fig. 5
Improvement of the cervical (a), forehead (b) and knee (c) lesions after 6 weeks of antibiotic treatment
Fig. 6
Fig. 6
PET scan images from cervical, forearm and knee lesions at the diagnosis (a–c) and after antibiotic treatment (d–f)
See this image and copyright information in PMC

References

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