Actinomyces in Chronic Granulomatous Disease: An Emerging and Unanticipated Pathogen

• DOI: 10.1086/647945
• Publication Date: 2009-10-29T21:45:22Z
• Authors: Janine Reichenbach; Uri Lopatin; Nizar Mahlaoui; Bojana Beovic; Ulrich Siler; Reinhard Zbinden; Reinhard A. Seger; Louise Galmiche; Nicole Brousse; Samer Kayal; Tayfun Güngör; Stéphane Blanche; Steven M. Holland
• Keywords: Chronic Granulomatous Disease; Actinomycosis

Background.Chronic granulomatous disease (CGD) is a rare inherited of the phagocyte NADPH oxidase system that causes defective production toxic oxygen metabolites, impaired bacterial and fungal killing, recurrent life-threatening infections, mostly by catalase-producing organisms. We report for first time, to our knowledge, chronic infections with Actinomyces species in 10 patients CGD. Actinomycosis condition commonly manifests as cervicofacial, pulmonary, or abdominal disease, caused slowly progressive infection oral gastrointestinal commensal species. Treatment actinomycosis usually simple immunocompetent individuals, requiring long-term, high-dose intravenous penicillin, but more complicated those CGD because delayed diagnosis an increased risk invasive debilitating disease. Methods.Actinomyces was identified culture, staining, 16S ribosomal DNA polymerase chain reaction, and/or complement fixation test Results.All presented history fever elevated inflammatory signs without evident focus. Diagnosis clinical course severe protracted despite antibiotic therapy surgery. These results suggest unrecognized unanticipated susceptibility weakly pathogenic these are catalase-negative organisms previously thought be nonpathogenic Conclusions.Actinomycosis should vigorously sought promptly treated presenting uncommon prolonged infection. important consider