A Long-Term Chronic Scrotal Actinomycosis in a MiddleAged Patient in Kerman
AbstractActinomyces species are non-spore forming Gram-positive bacilli. They are part of human/animal’s micro-ﬂora and are also among soil inhabitants. Actinomycosis is an opportunisic, indolent, slow growing, chronic progressive and granulomatous infection caused primarily by Actinomyces israelii. Less than 100 cases of Actinomyces nueii isolates have been reported in the literature. Our case is a 47-year-old man who recognized two painless nodules in his scrotum six months after military training. He did not reveal his problem. Ten years later, both lesions inﬂamed and ruptured. He had been treated empirically. About 15 years later, the inﬂammation reappeared along with general sign and symptoms of acute disseminated infectious disease. In microbiology examination, Actinomyces neuii was isolated from purulent aspirate of scrotal lesions. Along with surgical drainage of abscess, he was treated with antibiotics. Physicians mus remember that chronic, not purulent lesions of Actinomyces may be misdiagnosed with malignancies, too. Some patients like our case may ignore mild sexual disease for its anatomic site. This ignorance may lead to a severe infection.
Crescencio JCR, Koshy R. Postoperative testicular abscess with bacteremia due to Actinomyces neuii. ID Cases. 2014; 1: 36–37.
valour F, Sénéchal A, Dupieux C, Karsenty J, Lustig S, et al. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management. Infection and Drug Resistance. 2014;7:183–197.
Tille PM. Baily &scott's Diagnostic Microbiology,Elsevier. Fourteenth Edition.2017.p. 319-322.
Abi R, Tagajdid MR, Janvier F, Bousquet A, Larréché S, Mérens A. Scrotal abscess caused by actinomycosis turicensis: about an observation and literature review, Case Report. Int J Res Med Sci. 2017 ;5(4):1692-1694.
Chatterjee M. Gluteal primary cutaneous actinomycosis. Indian J Dermatol. 2005,50:152-4.
Lin CY, Jwo SC, Lin CC. Primary testicular actinomycosis mimicking metastatic tumor. International Journal of Urology. 2005; 12: 519–521.
Jani An, Casibang V, Mufarrij Wa. Disseminated actinomycosis presenting as a testicular mass: A Case Report. J Urol. 1990; 143: 1012- 1014.
Zelyas N, Gee S, Nilsson B, Bennett T, Rennie R. Infections Caused by Actinomyces neuii: A Case Series and Review of an Unusual Bacterium. Can J Infect Dis Med Microbiol. 2016; 2016:1- 7.
Ayers K M, wroe GE, de paoli A. Actinomycosis of the Testes and Spermatic Cord in a Dog. Vet. Pathol. 1997; 14: 287-288.
Chudackova E, Geigerova L, Hrabak J, Bergerova T, et al. Seven, isolates of actinomyces turicensis from patients with surgical infections of the anogenital area in a czech hospital. Journal Of Clinical Microbiology.2010; 48(7):2660–2661.
Cha EJ, Jang KY, Park HS, Park JK, Lee CS ,Chung MJ, et al. Actinomycosis of the penile shaft coexisting with fibrous pseudotumor of the testis pseudotumors of the testis. The Korean Journal of Pathology. 2008; 42: 50-3.
Rahimi Dehgolan S, Hosseini Shokouh SJ, Noorifard M, Dabbagh Moghaddam A, Tabibian E. Epidemiology of Superficial Fungal Infections in Iran Army Personnel. J Arch Mil Med. 2014; 2(2): 1-4.