Paediatric actinomycosis: a 16-year, single-institution retrospective review of cases
Aim: Actinomycosis is a rare subacute to chronic granulomatous infection which can mimic other infectious or malignant diseases. This study examined the epidemiology and treatment outcome of actinomycosis in children. Methods: A retrospective study on children admitted for actinomycosis in a tertiar...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
2024
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| Online Access: | https://hdl.handle.net/10356/174555 |
| _version_ | 1811686299187281920 |
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| author | Chew, Siu-Jun Low, Kelly B. B. Chong, Chia Yin Maiwald, Matthias Thoon, Koh Cheng Ong, Rina Y. L. Yung, Chee Fu Li, Jiahui Nadua, Karen Donceras Kam, Kai-Qian Tan, Henry K. K. Lian, Derrick W. Q. Tan, Leon Y. R. Tan, Natalie Woon Hui |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Chew, Siu-Jun Low, Kelly B. B. Chong, Chia Yin Maiwald, Matthias Thoon, Koh Cheng Ong, Rina Y. L. Yung, Chee Fu Li, Jiahui Nadua, Karen Donceras Kam, Kai-Qian Tan, Henry K. K. Lian, Derrick W. Q. Tan, Leon Y. R. Tan, Natalie Woon Hui |
| author_sort | Chew, Siu-Jun |
| collection | NTU |
| description | Aim: Actinomycosis is a rare subacute to chronic granulomatous infection which can mimic other infectious or malignant diseases. This study examined the epidemiology and treatment outcome of actinomycosis in children. Methods: A retrospective study on children admitted for actinomycosis in a tertiary paediatric hospital in Singapore, from January 2004 to December 2020. Clinical profile, therapeutic interventions and outcomes were examined. Results: A total of 10 patients were identified; 7 were female. The median age at first presentation was 9.8 years (range 4.7–15.7). The most common presenting symptom was fever (n = 6, 60%), followed by facial or neck swelling (n = 3, 30%) and ear pain (n = 3, 30%). Actinomycosis occurred predominantly in the orocervicofacial region (n = 6, 60%). Four patients (40%) had preceding dental infections in the form of dental caries or gingivitis. One patient had poorly controlled insulin-dependent diabetes mellitus. Actinomycosis was confirmed via culture in four patients, histopathology in four patients and both methods in two patients. All except one patient (n = 9, 90%) underwent surgical procedures. All patients received ampicillin or amoxicillin/clavulanate or other beta-lactams, for a median duration of 6.5 months (range 1.5–14). Complications included osteomyelitis (n = 4, 40%), mastoiditis (n = 2, 20%), brain abscess (n = 1, 10%) and recurrent neck abscess (n = 1, 10%). There was no mortality and all patients achieved complete resolution. Conclusions: Paediatric actinomycosis was rare in our 16-year review, but had a high complication rate. It can occur in immunocompetent patients, and dental infection was the predominant risk factor identified. Prognosis was excellent after surgical intervention and appropriate antimicrobial therapy. |
| first_indexed | 2024-10-01T04:58:12Z |
| format | Journal Article |
| id | ntu-10356/174555 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T04:58:12Z |
| publishDate | 2024 |
| record_format | dspace |
| spelling | ntu-10356/1745552024-04-07T15:41:18Z Paediatric actinomycosis: a 16-year, single-institution retrospective review of cases Chew, Siu-Jun Low, Kelly B. B. Chong, Chia Yin Maiwald, Matthias Thoon, Koh Cheng Ong, Rina Y. L. Yung, Chee Fu Li, Jiahui Nadua, Karen Donceras Kam, Kai-Qian Tan, Henry K. K. Lian, Derrick W. Q. Tan, Leon Y. R. Tan, Natalie Woon Hui Lee Kong Chian School of Medicine (LKCMedicine) KK Women's and Children's Hospital Yong Loo Lin School of Medicine, National University of Singapore Duke-National University of Singapore Medical School Medicine, Health and Life Sciences Abscess Actinomycosis Aim: Actinomycosis is a rare subacute to chronic granulomatous infection which can mimic other infectious or malignant diseases. This study examined the epidemiology and treatment outcome of actinomycosis in children. Methods: A retrospective study on children admitted for actinomycosis in a tertiary paediatric hospital in Singapore, from January 2004 to December 2020. Clinical profile, therapeutic interventions and outcomes were examined. Results: A total of 10 patients were identified; 7 were female. The median age at first presentation was 9.8 years (range 4.7–15.7). The most common presenting symptom was fever (n = 6, 60%), followed by facial or neck swelling (n = 3, 30%) and ear pain (n = 3, 30%). Actinomycosis occurred predominantly in the orocervicofacial region (n = 6, 60%). Four patients (40%) had preceding dental infections in the form of dental caries or gingivitis. One patient had poorly controlled insulin-dependent diabetes mellitus. Actinomycosis was confirmed via culture in four patients, histopathology in four patients and both methods in two patients. All except one patient (n = 9, 90%) underwent surgical procedures. All patients received ampicillin or amoxicillin/clavulanate or other beta-lactams, for a median duration of 6.5 months (range 1.5–14). Complications included osteomyelitis (n = 4, 40%), mastoiditis (n = 2, 20%), brain abscess (n = 1, 10%) and recurrent neck abscess (n = 1, 10%). There was no mortality and all patients achieved complete resolution. Conclusions: Paediatric actinomycosis was rare in our 16-year review, but had a high complication rate. It can occur in immunocompetent patients, and dental infection was the predominant risk factor identified. Prognosis was excellent after surgical intervention and appropriate antimicrobial therapy. Published version 2024-04-02T05:54:32Z 2024-04-02T05:54:32Z 2023 Journal Article Chew, S., Low, K. B. B., Chong, C. Y., Maiwald, M., Thoon, K. C., Ong, R. Y. L., Yung, C. F., Li, J., Nadua, K. D., Kam, K., Tan, H. K. K., Lian, D. W. Q., Tan, L. Y. R. & Tan, N. W. H. (2023). Paediatric actinomycosis: a 16-year, single-institution retrospective review of cases. Journal of Paediatrics and Child Health, 59(6), 833-839. https://dx.doi.org/10.1111/jpc.16400 1034-4810 https://hdl.handle.net/10356/174555 10.1111/jpc.16400 37017147 2-s2.0-85152017098 6 59 833 839 en Journal of Paediatrics and Child Health © 2023 The Authors. Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians). This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. application/pdf |
| spellingShingle | Medicine, Health and Life Sciences Abscess Actinomycosis Chew, Siu-Jun Low, Kelly B. B. Chong, Chia Yin Maiwald, Matthias Thoon, Koh Cheng Ong, Rina Y. L. Yung, Chee Fu Li, Jiahui Nadua, Karen Donceras Kam, Kai-Qian Tan, Henry K. K. Lian, Derrick W. Q. Tan, Leon Y. R. Tan, Natalie Woon Hui Paediatric actinomycosis: a 16-year, single-institution retrospective review of cases |
| title | Paediatric actinomycosis: a 16-year, single-institution retrospective review of cases |
| title_full | Paediatric actinomycosis: a 16-year, single-institution retrospective review of cases |
| title_fullStr | Paediatric actinomycosis: a 16-year, single-institution retrospective review of cases |
| title_full_unstemmed | Paediatric actinomycosis: a 16-year, single-institution retrospective review of cases |
| title_short | Paediatric actinomycosis: a 16-year, single-institution retrospective review of cases |
| title_sort | paediatric actinomycosis a 16 year single institution retrospective review of cases |
| topic | Medicine, Health and Life Sciences Abscess Actinomycosis |
| url | https://hdl.handle.net/10356/174555 |
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