Disseminated infection due to Actinomyces meyeri: case report and review

Actinomyces meyeri is rarely isolated in cases of actinomycosis. We present a case of disseminated actinomycosis due to A. meyeri; the patient had an abscess of the lung, osteomyelitis of the tibia, and multiple skin abscesses. Cure was achieved with surgical debridement and administration of intravenous penicillin, followed by oral penicillin, for 1 year. A concomitant gram-negative bacillus, Actinobacillus actinomycetemcomitans, was also isolated. Review of the literature revealed only 26 well-documented cases of infection with A. meyeri. Male adults are mainly affected, and alcoholism is frequently the underlying condition in these patients. Associated bacteria were isolated in two-thirds of these cases. In contrast to other species of Actinomyces, A. meyeri often causes pulmonary infection and shows a tendency for hematogenous dissemination. Even though multiple organs are involved, the outcome for these patients is excellent when penicillin is administered for several months and surgical procedures are performed when necessary.