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Refractory actinomycosis of the humerus.
Mariano O Abrego1, Franco L De Cicco1, Noelia B Montenegro1
1Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
SAGE Open Medical Case Reports
|January 20, 2018
Summary
Actinomycosis, a rare bone infection, can be challenging to diagnose and treat. This case highlights the difficulty in identifying Actinomyces in humerus infections, even with prolonged cultures, suggesting surgery may be necessary.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Actinomycosis is a chronic, opportunistic infection caused by Actinomyces species.
- Primary actinomycosis affecting long bones, particularly the humerus, is exceptionally rare.
Observation:
- A 66-year-old male presented with a refractory humerus tumor, diagnosed as actinomycosis after a 20-year history post-trauma.
- Despite extensive culturing (21 days, aerobic/anaerobic), Actinomyces was not isolated.
- The patient underwent multiple surgeries and prolonged antibiotic therapy with suboptimal results.
Findings:
- Diagnosis of primary humeral actinomycosis is challenging due to non-specific symptoms and difficulty in organism isolation.
- Standard antibiotic treatment may be insufficient for long bone actinomycosis.
Implications:
- This case underscores the rarity and diagnostic challenges of humerus actinomycosis.
- Surgical intervention should be strongly considered when antibiotic therapy proves ineffective.
- Further research into optimal diagnostic and therapeutic strategies for rare bone actinomycosis is warranted.
