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Actinomyces meyeri: from "lumpy jaw" to empyema.

A Attaway¹, T Flynn

¹Western Michigan University School of Medicine, 1000 Oakland Dr, Kalamazoo, MI, 49008, USA, amy.attaway@med.wmich.edu.

|March 28, 2013

Summary

Actinomyces meyeri, a bacterium, can cause severe lung infections and spread to other organs. This case highlights a rare presentation of pulmonary actinomycosis with empyema, successfully treated with antibiotics and dental extraction.

Area of Science:

Medical Microbiology
Infectious Diseases
Pulmonology

Background:

Actinomycosis is typically a cervicofacial infection, but certain species like *Actinomyces meyeri* exhibit a propensity for pulmonary involvement.
Dissemination to distant organs can occur, complicating the clinical presentation and management.
Understanding atypical presentations is crucial for timely diagnosis and effective treatment.

Observation:

A 61-year-old male presented with a recurrent mandibular sinus tract, later developing constitutional symptoms including weight loss, dyspnea, and productive cough.
Imaging demonstrated right lower lobe pneumonia and a significant left-sided empyema.
Thoracotomy revealed and drained 1 liter of purulent fluid, with cultures confirming *Actinomyces meyeri*.

Findings:

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The patient was diagnosed with pulmonary actinomycosis complicated by empyema, caused by *Actinomyces meyeri*.
Successful management involved an extended course of antibiotics and extraction of teeth.
This case underscores the importance of considering actinomycosis in patients with persistent respiratory symptoms and sinus tracts.

Implications:

This case expands the understanding of *Actinomyces meyeri*'s pathogenic potential, particularly in the pulmonary system.
Prompt diagnosis and comprehensive treatment, including source control (dental extraction), are vital for favorable outcomes in disseminated actinomycosis.
Further research into the specific virulence factors and host-pathogen interactions of *A. meyeri* may elucidate its predilection for pulmonary disease.