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Atypical inflammation of the soft tissue, most likely caused by Actinomyces infection – a case report

Beata Jurkiewicz1, Łukasz Jankowski2, Joanna Samotyjek2, Katarzyna Załęska2, Grzegorz Gut2, Danuta Rewicka2

Affiliation and address for correspondence
Pediatr Med Rodz 2016, 12 (3), p. 337–343
DOI: 10.15557/PiMR.2016.0035
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Abstract

Actinomycosis is a very rare cause of inflammation of the labial soft tissue in girls. It is characterised by hard inflammatory infiltrates accompanied by fibrosis, abscesses and fistulas. The non-specific course of the disease makes a correct diagnosis difficult. In this paper, we have presented diagnostic and therapeutic difficulties in the inflammation of the labial soft tissue of probable actinomycotic aetiology in a 7-year-old girl. The patient was hospitalised twice, including three surgical procedures due to labial tissue inflammation and abscess. Methicyllin-resistant Staphylococcus aureus was cultured from the abscess content. Systemic antibiotics from six different classes were used; however, no improvement in the local condition was achieved. The abscess was irrigated with gentamicin solution; steroid ointments and physical therapy were used, but with no effect. A suspicion of actinomycotic infection was raised due to the chronic course of the disease and poor response to treatment. Penicillin was administered for a total period of 3 months, resulting in rapid improvement and, ultimately, a complete recovery of the child. Although the actinomycotic aetiology was not confirmed by cultures or histopathological examination, the course of the therapy has allowed to suspect Actinomyces infection.

Keywords
actinomycosis, antibiotic therapy, inflammation, abscess

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