TY - JOUR
T1 - Case report of an unusual hepatic abscess caused by Actinomyces odontolyticus in a patient with human immunodeficiency virus infection
AU - Hsu, Shao Lun
AU - Wu, Chin Ting
AU - Chang, Yuan Chen
AU - Fan, Chia Kwung
AU - Lee, Yuarn Jang
N1 - Funding Information:
We thank the study participants, Chin-Ting Wu for assistance with figures, and staff in the medical laboratory department of Taipei Medical University (TMU) who assisted in performing the confirmation test. In addition, we thank Yuarn-Jang Lee and the clinical workers of TMU infectious diseases for their contribution to the clinical care of the patient and Yuan-Chen Chang for her assistance in obtaining the approval of the TMU-Joint Institutional Review Board (Grant No: N201911019). This manuscript was edited by Wallace Academic Editing, we thank their efforts in revised and improved the manuscript.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: Actinomyces odontolyticus is not commonly recognized as a causative microbe of liver abscess. The detection and identification of A. odontolyticus in laboratories and its recognition as a pathogen in clinical settings can be challenging. However, in the past decades, knowledge on the clinical relevance of A. odontolyticus is gradually increasing. A. odontolyticus is the dominant oropharyngeal flora observed during infancy [Li et al. in Biomed Res Int 2018:3820215, 2018]. Herein we report a case of severe infection caused by A. odontolyticus in an immunocompromised patient with disruption of the gastrointestinal (GI) mucosa. Case presentation: We present a unique case of a patient with human immunodeficiency virus infection who was admitted due to liver abscess and was subsequently diagnosed as having coinfection of A. odontolyticus, Streptococcus constellatus, and Candida albicans during the hospital course. The empirical antibiotics metronidazole and ceftriaxone were replaced with the intravenous administration of fluconazole and ampicillin. However, the patient’s condition deteriorated, and he died 3 weeks later. Conclusion: This report is one of the first to highlight GI tract perforation and its clinical relevance with A. odontolyticus infection. A. odontolyticus infection should be diagnosed early in high-risk patients, and increased attention should be paid to commensal flora infection in immunocompromised individuals.
AB - Background: Actinomyces odontolyticus is not commonly recognized as a causative microbe of liver abscess. The detection and identification of A. odontolyticus in laboratories and its recognition as a pathogen in clinical settings can be challenging. However, in the past decades, knowledge on the clinical relevance of A. odontolyticus is gradually increasing. A. odontolyticus is the dominant oropharyngeal flora observed during infancy [Li et al. in Biomed Res Int 2018:3820215, 2018]. Herein we report a case of severe infection caused by A. odontolyticus in an immunocompromised patient with disruption of the gastrointestinal (GI) mucosa. Case presentation: We present a unique case of a patient with human immunodeficiency virus infection who was admitted due to liver abscess and was subsequently diagnosed as having coinfection of A. odontolyticus, Streptococcus constellatus, and Candida albicans during the hospital course. The empirical antibiotics metronidazole and ceftriaxone were replaced with the intravenous administration of fluconazole and ampicillin. However, the patient’s condition deteriorated, and he died 3 weeks later. Conclusion: This report is one of the first to highlight GI tract perforation and its clinical relevance with A. odontolyticus infection. A. odontolyticus infection should be diagnosed early in high-risk patients, and increased attention should be paid to commensal flora infection in immunocompromised individuals.
KW - Actinomyces odontolyticus
KW - Candida albicans
KW - Human immunodeficiency virus
KW - Liver abscess
KW - Streptococcus constellatus
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U2 - 10.1186/s12879-021-06703-6
DO - 10.1186/s12879-021-06703-6
M3 - Article
C2 - 34556028
AN - SCOPUS:85115411935
SN - 1471-2334
VL - 21
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 1
M1 - 998
ER -