1 Thoracic Vertebral Actinomycosis: Actinomyces israelii and Fusobacterium nucleatum Hitoshi ...

1 Thoracic Vertebral Actinomycosis: Actinomyces israelii and Fusobacterium nucleatum Hitoshi ...

18 Pages · 2008 · 227 KB · English

1. Thoracic Vertebral Actinomycosis: Actinomyces israelii and Fusobacterium nucleatum. Hitoshi Honda. 1. , Matthew J. Bankowski. 2*. , Eric H.N. Kajioka .. Alcohol abuse. Cerebral involvement. 2006. A. israelii. 38/M. None. 2006. 8weeks of IV metronidazole with IV penicillin G. 12 months of amoxici

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1 T horacic Vertebral Actinomycosis: Actinomyces israelii and Fusobacterium nucleatum Hitoshi Honda 1 , M atthew J Bankowski 2* , Eric HN Kajioka 3 , Nalurporn Chokrungvaranon 4 , Wesley Kim 2 , and Scott T Gallacher 4 Washington University School of Medicine, Division of Infectious Diseases, St Louis, Missouri 1 , Diagnostic Laboratory Services, Inc and John A Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 2 , University of Colorado, Division of Infectious Diseases, Denver, Colorado 3 , University of Hawaii Internal Medicine Residency Program, Department of Internal Medicine, Honolulu, Hawaii 4 Keywords: Actinomyces Fusobacterium Central nervous system Corresponding author: Matthew J Bankowski, PhD, D(ABMM) Diagnostic Laboratory Services, Inc Department of Clinical Microbiology 650 Iwilei Road, Suite 300 Honolulu, HI 96817 Tel: (808) 5895242 Fax: (808) 5895215 [email protected] Word count: 2309 ACCEPTED Copyright © 2008, American Society for Microbiology and/or the Listed\ Authors/Institutions All Rights Reserved J Clin Microbiol doi:101128/JCM0170607 JCM Accepts, published online ahead of print on 12 March 2008 on September 23, 2017 by guest http://jcmasmorg/ Downloaded from 2 A bstract Actinomyces spp is considered a rare pathogen in today’s medicine, especially with thoracic vertebral involvement Classic actinomycosis (50%) presents as an oral cervicofacial (“Lumpy Jaw“) infection This report describes a case of spinal cord compression caused by Actinomyces israelii with coisolation of Fusobacterium nucleatum There are limited numbers of similar cases ACCEPTED on September 23, 2017 by guest http://jcmasmorg/ Downloaded from 3 C ase Report Introduction This case involves a 43 year old Filipino male who presented to a medical center emergency department with a chief complaint of acute lower back pain and urinary incontinence He had been in his usual state of health until approximately three days prior to admission when he first noticed a gradual onset of bilateral lower extremity weakness followed by difficulty with walking, and finally inability to arise from bed In addition, the patient stated that he had been experiencing low grade fevers and progressive weight loss over the past several months His past medical history was unremarkable and did not include any recent trauma The patient emigrated from the Philippines to Hawaii about 20 years ago However, he denied any history of exposure to tuberculosis or any recent travel history back to the Philippines or South East Asia In the emergency room the patient appeared disoriented although he was able to follow simple commands His vital signs included a temperature of 978 F, blood pressure 121/75, heart rate of 116/min, and mild tachypnea with an O 2 saturation of 99% on room air On physical examination, he was noted to have poor dentition with evidence of multiple previous dental extractions Neurologic examination revealed significant bilateral lower extremity weakness (2 out of 5) with brisk deep tendon reflexes, positive ankle clonus, and positive Babinski signs, as well as diminished rectal tone The remainder of the physical exam was unremarkable Laboratory blood findings were significant for a leukocytosis (220 x 10(9)/L) with 87% segmented neutrophils, an elevated platelet count of 722 x 10(6)/L, and an erythrocyte sedimentation rate of 84 mm/hr An HIV1/2 antibody screen was negative The remaining labs were non ACCEPTED on September 23, 2017 by guest http://jcmasmorg/ Downloaded from 4 c ontributory A chest xray showed a left lower lobe infiltrate with minimal pleural effusion Because of

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