Actinomyces neuii , an Uncommon Pathogen in a Soft Tissue Infection: a Case Report
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MEDICINE
Actinomyces neuii, an Uncommon Pathogen in a Soft Tissue Infection: a Case Report J. Masso-Bueso 1 & D. Cabello-Modesto 1 L. Guevara-Arnal 1
&
C. Brown-Escobar 1 & M. Santiago-Benítez 1 & E. Montalvo-Javé 1,2,3 &
Accepted: 16 September 2020 # Springer Nature Switzerland AG 2020
Abstract Actinomycosis remains an underdiagnosed disease, especially in situations such as those specifically caused by Actinomyces neuii, a pathogen that naturally inhabits normal flora but has become implicated as a cause of sepsis and has been observed over a wide age range, and we continue discovering unusual places that can have this pathogen as an infectious origin or as mixed infections. Keywords Actinomyces neuii . Lumbar abscess . Soft tissue infection
Introduction Actinomyces neuii is a rare Gram-positive organism that has been isolated in various contexts from both invasive and noninvasive infectious clinical presentations with relevant clinical significance. It has been shown to have interesting behavior as well as characteristics that differentiate it from other species of Actinomyces spp., like not having filaments or being a producer of granules, in addition to showing an ability to grow anaerobically and aerobically [1]. It has been observed in a fairly wide age range, from reports of chorioamnionitis with subsequent sepsis in newborns to heart valve infections with successful response to treatment in the elderly, which leads us to take into account that it does not generate an actinomycosis in a typical way [2–4].
We know that abscess is the most commonly reported clinical manifestation and there is a certain predilection in anatomical areas such as in the mammary, axillary, and inguinal areas; however, its anatomical location is highly variable as in the case presented below [5, 6]. In Mexico, there is little reported literature about infections caused by A. neuii, as well as worldwide, that is why the importance arises of publicizing this case, as well as the characteristics of its clinical presentation, knowledge, and the use of useful tools such as the MALDI-TOF MS for proper diagnostic and therapeutic approach, since a delay in diagnosis can lead to a fatal imbalance with a potentially treatable microorganism [7].
Case This article is part of the Topical Collection on Medicine Electronic supplementary material The online version of this article (https://doi.org/10.1007/s42399-020-00525-4) contains supplementary material, which is available to authorized users. * D. Cabello-Modesto [email protected] 1
Hospital Médica Sur, Puente de Piedra 150, Toriello Guerra, Tlalpan, 14050 Mexico city, Mexico
2
General Surgery Service, General Hospital of México “Dr. Eduardo Liceaga”, Mexico city, Mexico
3
Surgery Department, UNAM Medicine Faculty, Mexico city, Mexico
A 74-year-old male with a history of obesity, pre-diabetes, chronic venous insufficiency, prostatic hyperplasia, and excision of pilonidal cyst in 1975. Initially, the case was presented as a patient with a nonpainful lumbar mass approach, with e
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