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Arachnia propionica (Actinomyces propionicus) as an unusual agent in tympanomastoiditis
Abstract:
The actinomycetes are extremely uncommon causative agents in chronic tympanomastoiditis. Few cases have been reported in the literature, and, before the use of penicillin, the majority of patients died of intracranial extension of their disease. Two patients described in the recent literature could have had their conditions diagnosed preoperatively as cholesterol granuloma. They had intact but immobile or bulging tympanic membranes and histories of intermittent perforations with drainage. The diagnosis was suggested during surgery because of the presence of yellow-green amorphous "sulfur granules" scattered throughout the mastoid. Both patients were well following mastoidectomy and long-term penicillin therapy. The clinical history of a patient with tympanomastoiditis due to Arachnia propionica (Actinomyces propionicus) is discussed. To our knowledge, this is the first case reported of a patient with otic disease due to this strain of the organism.
Insights
Actinomycetes are rare causes of chronic tympanomastoiditis. This report details a case of otic disease due to Arachnia propionica, highlighting diagnostic clues and successful treatment.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- Actinomycetes are infrequent pathogens in chronic tympanomastoiditis.
- Historically, intracranial complications led to high mortality before antibiotics.
Observation:
- Two patients presented with intact, immobile tympanic membranes, mimicking cholesterol granuloma.
- Intraoperative findings of "sulfur granules" suggested actinomycosis.
Findings:
- This case represents the first reported instance of otic infection caused by Arachnia propionica (Actinomyces propionicus).
- Mastoidectomy and long-term penicillin therapy resulted in positive patient outcomes.
Implications:
- Highlights the importance of considering actinomycosis in refractory chronic tympanomastoiditis.
- Early diagnosis and appropriate antibiotic treatment are crucial for managing actinomycotic infections.