Biography
Dr Nancy Klaudia Brulinska BSc BMBs works as an emergency doctor in University Hospital Limerick. She has graduated with Medicine and Surgery degree from University of Limerick before which she has studied and received a Bioanalysis and Biotechnology Bachelors degree. Her plan is to complete Masters of Infectious diseases and to progress her career in the field of Emergency Medicine.
BACKGROUND:
The Actinomycosis is a bacterial infection caused by Gram positive, non-acid fast, anaerobic or microacrophilic rods. Actinomycetes can be found in the normal flora of the oral cavity, as well as less commonly in the lower GIT and female genital tract but are not virulent. Actinomycosis of the abdomen and pelvis accounts for 10-20% of reported cases. Untreated, pyogenic liver abscess remains uniformly fatal. With timely administration of antibiotics and drainage procedures, mortality currently occurs in 5-30%. The most common causes of death include sepsis, multiorgan failure, and hepatic failure.
CASE HISTORY:
This is a case report of 57 year old male presenting with flu like symptoms, high fever, myalgia and very mil right upper quadrant pain. There was no medical history of note. Initially treated as infection of unknown source. Blood cultures ultimately grew actinomycosis oris. CT Abdomen/Pelvis showed an 8.5cm liver abscess, predominantly located within segment 5. Some mural thickening of the distal oesophagus with periesophageal and coeliac axis lymph nodes was also noted. He was followed up with OGD which showed a hiatus hernia and gastritis. Treatment was with IV antibiotics (piperacillin/tazobactam) for 6 weeks and CT guided drainage of the abscess. The drain was removed after 3 weeks.