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Persistent Multispecies Actinomyces Mastitis Treated With Repeated Aspiration and Long-Term Oral Antibiotics
Colin Jenkins1, Anand Ganapathy2, Crystal Fancher2
1Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Abstract:
Actinomycosis is an infection characterized by abscess formation, draining sinuses, and tissue fibrosis. The causative bacterium is a Gram-positive facultative anaerobe from the genus Actinomyces. Infections classically affect the cervicofacial, thoracic, or pelvic region and often require prolonged antibiotic therapy. Actinomycosis of the breast is a rare condition that may present as a recurrent breast abscess. We present a 33-year-old female with a recurrent breast abscess which grew A. radingae and A. israeli on aspirated fluid cultures. Treatment with surgical aspiration and a 6-week course of oral amoxicillin/clavulanic acid 875 mg twice daily resulted in clinical improvement. Our case demonstrates how recurrent breast abscesses caused by Actinomyces can be difficult to manage. Long-term antibiotic therapy with surgical aspiration and regular follow-up offer the best chance of clinical resolution.
Insights
Actinomycosis, a rare breast infection, can cause recurrent abscesses. This case highlights successful management through surgical aspiration and a 6-week antibiotic course, emphasizing long-term therapy for resolution.
Area of Science:
- Infectious Diseases
- Microbiology
Background:
- Actinomycosis is a bacterial infection caused by Gram-positive anaerobes of the genus *Actinomyces*.
- It typically presents with abscesses, draining sinuses, and fibrosis, often affecting cervicofacial, thoracic, or pelvic regions.
- Breast actinomycosis is rare, frequently manifesting as recurrent breast abscesses requiring prolonged treatment.
Observation:
- A 33-year-old female presented with a recurrent breast abscess.
- Aspiration of the abscess revealed cultures positive for *Actinomyces radingae* and *Actinomyces israelii*.
Findings:
- The patient received treatment involving surgical aspiration and a 6-week course of oral amoxicillin/clavulanic acid (875 mg twice daily).
- This therapeutic approach resulted in significant clinical improvement.
Implications:
- Recurrent breast abscesses caused by *Actinomyces* species present management challenges.
- Effective treatment strategies include long-term antibiotic therapy, surgical intervention, and consistent patient follow-up.
- This case underscores the importance of considering actinomycosis in the differential diagnosis of persistent or recurrent breast abscesses.
