Actinomycosis differential diagnosis: Difference between revisions

Jump to navigation Jump to search
Line 7: Line 7:


==Differential Diagnosis==
==Differential Diagnosis==
Actinomycosis should be differentiated from other conditions with similar presentation:<ref name="pmid17560191">{{cite journal| author=Yiğiter M, Kiyici H, Arda IS, Hiçsönmez A| title=Actinomycosis: a differential diagnosis for appendicitis. A case report and review of the literature. | journal=J Pediatr Surg | year= 2007 | volume= 42 | issue= 6 | pages= E23-6 | pmid=17560191 | doi=10.1016/j.jpedsurg.2007.03.057 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17560191  }} </ref><ref name="pmid19149697">{{cite journal |vauthors=Hasper D, Schefold JC, Baumgart DC |title=Management of severe abdominal infections |journal=Recent Pat Antiinfect Drug Discov |volume=4 |issue=1 |pages=57–65 |year=2009 |pmid=19149697 |doi= |url=}}</ref><ref name="pmid15342974">{{cite journal |author=Lederman ER, Crum NF |title=A case series and focused review of nocardiosis: clinical and microbiologic aspects |journal=Medicine (Baltimore) |volume=83 |issue=5 |pages=300–13 |year=2004 |month=September |pmid=15342974 |doi= 10.1097/01.md.0000141100.30871.39|url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0025-7974&volume=83&issue=5&spage=300}}</ref><ref>{{cite book | last = Hoffman | first = Barbara | title = Williams gynecology | publisher = McGraw-Hill Medical | location = New York | year = 2012 | isbn = 9780071716727 }}</ref>
Actinomycosis should be differentiated from other conditions with similar presentation:<ref name="pmid17560191">{{cite journal| author=Yiğiter M, Kiyici H, Arda IS, Hiçsönmez A| title=Actinomycosis: a differential diagnosis for appendicitis. A case report and review of the literature. | journal=J Pediatr Surg | year= 2007 | volume= 42 | issue= 6 | pages= E23-6 | pmid=17560191 | doi=10.1016/j.jpedsurg.2007.03.057 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17560191  }} </ref><ref name="pmid19149697">{{cite journal |vauthors=Hasper D, Schefold JC, Baumgart DC |title=Management of severe abdominal infections |journal=Recent Pat Antiinfect Drug Discov |volume=4 |issue=1 |pages=57–65 |year=2009 |pmid=19149697 |doi= |url=}}</ref><ref name="pmid15342974">{{cite journal |author=Lederman ER, Crum NF |title=A case series and focused review of nocardiosis: clinical and microbiologic aspects |journal=Medicine (Baltimore) |volume=83 |issue=5 |pages=300–13 |year=2004 |month=September |pmid=15342974 |doi= 10.1097/01.md.0000141100.30871.39|url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0025-7974&volume=83&issue=5&spage=300}}</ref><ref>{{cite book | last = Hoffman | first = Barbara | title = Williams gynecology | publisher = McGraw-Hill Medical | location = New York | year = 2012 | isbn = 9780071716727 }}</ref><ref name="Humes2006">{{cite journal|last1=Humes|first1=D J|title=Acute appendicitis|journal=BMJ|volume=333|issue=7567|year=2006|pages=530–534|issn=0959-8138|doi=10.1136/bmj.38940.664363.AE}}</ref>  
{| class="wikitable"
{| class="wikitable"
!Disease
!Disease

Revision as of 17:53, 21 March 2017

Actinomycosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Actinomycosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Actinomycosis differential diagnosis On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Actinomycosis differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Actinomycosis differential diagnosis

CDC on Actinomycosis differential diagnosis

Actinomycosis differential diagnosis in the news

Blogs on Actinomycosis differential diagnosis

to Hospitals Treating Actinomycosis

Risk calculators and risk factors for Actinomycosis differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The differential diagnosis of actinomycosis consists of blastomycosis, brain abscess, colon cancer, crohn disease, diverticulitis, liver abscess, lung abscess, lymphoma, nocardiosis, pelvic inflammatory disease, pneumonia, tuberculosis and uterine cancer.

Differential Diagnosis

Actinomycosis should be differentiated from other conditions with similar presentation:[1][2][3][4][5]

Disease Differentiating signs/symptoms Differentiating tests
Abdominal Abscess Features of sepsis and signs of an acute abdomen are generally prominent Histology and culture for actinomycetes are negative.

Blood or site cultures identify etiologic organism.

Nocardiosis Immunocompromised host

Predominant pulmonary

Modified acid-fast staining of biopsy tissue or other samples allows distinction between Nocardia and Actinomyces
Ovarian/Oviductal tumor Systemic findings like weight loss ,night sweats present

No leukorrhea

Histopathology shows malignancy.
Appendicitis Rapid onset of symptoms

Positive for signs of appenidicitis

Ultrasound shows inflammation of appendix

Negative blood culture

Blastomycosis Self limited

Cutaneous manifestations along with lung involvement.

Endemic to Mississippi and Ohio river valley

Sputum smear and culture using KOH preparations or specific stains can confirm diagnosis
Colon cancer Systemic findings like weight loss, night sweats present

Anemia

Blood loss in stools

Colonoscopy identifies the lesions ,histopathology confirms the presence of the malignant cells.
Inflammatory bowel disease Dysentery

Weight loss

Colonoscopy identifies the ulcerative lesions
Lung abscess Risk of aspiration

Cough with foul smelling sputum

Polymicrobial infection
Pelvic inflammatory disease History of recent sexual contact or a sexually transmitted infection in the partner,

Past history of PID.

laparoscopy with biopsy sampling followed by histology.
Pulmonary tuberculosis Cough >2 weeks

Hemoptyisis

Night sweats, weight loss

Acid fast bacilli positive on sputum examination

Tuberculin skin testing positive. 

Whipple disease An acute GI illness, with fever, diarrhea, and weight loss

Malabsorption such as steatorrhea.

Abdominal lymphadenopathy and abdominal pain.

Joint problems

Anemia.

Anti-Tropheryma whipplei-positive macrophage.

PCR testing of duodenal biopsies positive for T whipplei

  • The clinical manifestations of actinomycosis and nocardiosis are similar. The following table helps in differentiating actinomycosis from nocardiosis.[6][7]
  • Differentiation of actinomycosis from nocardiosis is very important in selection of appropriate antimicrobial therapy.[8]
Actinomycosis Nocardiosis
Gram positive anaerobic species Gram positive aerobe
Decreasing incidence Increasing incidence
Occurs primarily in immunocompetent host Occurs primarily in immunocompromised host
Predominant cervicofacial Predominant pulmonary
Chest wall involvement and bony erosions are common Chest wall involvement is uncommon
Granuloma formation and intense fibrosis are common. Form characteristic sulfur granules Granuloma formation and fibrosis are uncommon
Spread by direct invasion Metastatic spread is common (especially to brain)
Diagnosis is made through cytologic or histologic examination Diagnosis is made through BAL (bronchoalveolar lavage),

sputum, or pleural fluid culture

Treatment: Penicillin

Treatment with antibiotics alone

Treatment: Sulfonamides

Often need surgical drainage

References

  1. Yiğiter M, Kiyici H, Arda IS, Hiçsönmez A (2007). "Actinomycosis: a differential diagnosis for appendicitis. A case report and review of the literature". J Pediatr Surg. 42 (6): E23–6. doi:10.1016/j.jpedsurg.2007.03.057. PMID 17560191.
  2. Hasper D, Schefold JC, Baumgart DC (2009). "Management of severe abdominal infections". Recent Pat Antiinfect Drug Discov. 4 (1): 57–65. PMID 19149697.
  3. Lederman ER, Crum NF (2004). "A case series and focused review of nocardiosis: clinical and microbiologic aspects". Medicine (Baltimore). 83 (5): 300–13. doi:10.1097/01.md.0000141100.30871.39. PMID 15342974. Unknown parameter |month= ignored (help)
  4. Hoffman, Barbara (2012). Williams gynecology. New York: McGraw-Hill Medical. ISBN 9780071716727.
  5. Humes, D J (2006). "Acute appendicitis". BMJ. 333 (7567): 530–534. doi:10.1136/bmj.38940.664363.AE. ISSN 0959-8138.
  6. Sullivan DC, Chapman SW (2010). "Bacteria that masquerade as fungi: actinomycosis/nocardia". Proc Am Thorac Soc. 7 (3): 216–21. doi:10.1513/pats.200907-077AL. PMID 20463251.
  7. Warren NG (1996). "Actinomycosis, nocardiosis, and actinomycetoma". Dermatol Clin. 14 (1): 85–95. PMID 8821161.
  8. Smego RA (1987). "Actinomycosis of the central nervous system". Rev Infect Dis. 9 (5): 855–65. PMID 3317731.

Template:Bacterial diseases

de:Aktinomykose gl:Actinomicose hr:Aktinomikoza nl:Actinomycose sr:Актиномикоза fi:Aktinomykoosi uk:Актиномікоз

Template:WikiDoc Sources