Mediastinal Actinomycosis After Esophagogastroduodenoscopy

Area of Science:

• Infectious Diseases
• Medical Case Reports
• Bacteriology

Background:

• Actinomycosis is a rare, indolent bacterial infection affecting multiple organ systems.
• Esophagogastroduodenoscopy (EGD) is a common diagnostic procedure.
• Mediastinal actinomycosis is an uncommon complication, often linked to invasive EGD procedures.

Observation:

• A 66-year-old female with end-stage renal disease presented with dyspnea and chest pain post-EGD.
• CT scan revealed a large mediastinal mass, initially suspected as malignancy.
• Biopsy confirmed mediastinal actinomycosis, despite no intentional mucosal disruption during EGD.

Findings:

• The patient received extended antibiotic therapy.
• Significant clinical improvement was observed following antibiotic treatment.
• This case highlights actinomycosis as a potential complication of diagnostic EGD.

Implications:

• Diagnostic EGD, even without invasive measures, can rarely lead to mediastinal actinomycosis.
• Prompt diagnosis and treatment are crucial for managing this uncommon infection.
• Further research may elucidate the mechanisms of actinomycosis transmission during non-invasive EGD.