Actinomycosis: A diagnosis not to be forgotten

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Salma Ben Hmida
Ichrak Bougharriou
Cyrine Mezghani
Lassaad Chtourou
Tarak Hchicha
Chakib Marrakchi
Zeineb Mnif
Tahya Sellami
Hela Karray
Mounir Ben jmeaa

Abstract

Introduction: Actinomycosis is a bacterial infection that presents a significant diagnostic


challenge for clinicians due to its rarity and chronic progression. Diagnosis is usually made


through pathological or microbiological examination, sometimes at the cost of unnecessary


and costly interventions.


The aim of this study is to illustrate the diagnostic difficulties of this pathology and to evaluate its therapeutic and progression aspects.


Methods: This is a retrospective study of actinomycosis cases collected between 1991 and 2023.


Results: We collected 17 cases of actinomycosis. They were 7 men and 10 women, with a


sex ratio (M/F) of 0,7 The mean age was 43 ±13 years. The mean time to diagnosis was 110


(30-540) days. The different locations were cervicofacial (7 cases), abdominal (2 cases),


pelvic (1 case), cerebral (3 cases), and disseminated (3 cases). The diagnosis was made


microbiologically in 4 cases and pathologically in 13 cases. The mean duration of antibiotic


therapy was 18 (3-35) days. Eight patients received surgical treatment associated with


antibiotic therapy. The outcome was favorable in 16 cases.


Conclusion: Actinomycosis can be confused with tumors or infections due to its variable


clinical presentation. Anatomopathological examination plays a crucial role in the diagnosis.


Prompt and appropriate treatment leads to a favorable prognosis, highlighting the importance


of enhanced awareness of this condition to optimize disease management.

Keywords:

Actinomyces, penicillin, Actinomycosis

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