ELDE PRİMER ACTINOMYCOSIS: ANTİTENİN NADİR YERLEŞİMİ OLGU SUNUMU

Öz

Actinomycosis endojen gram pozitif bakteri olan Actinomyces’in etken olduğu kronik, granulomatöz süpüratif bir enfeksiyondur. Sıklıkla baş, boyun, toraks ve abdomende görülmektedir. El yerleşimli, subkutan doku ve kemik tutulumu oldukça nadir görülmektedir. Hastanemize elde beş yıldır geçmeyen yarası nedeniyle başvuran 54 yaşındaki erkek hastada, doku biyopsisinin histopatolojik incelenmesinde nötrofiller ile çevrelenmiş bazofilik sülfür granüllerinin varlığı ve bu granüllerin içinde gram-pozitif, asitfast negatif filamentöz basillerin saptanması ile Actinomycosis tanısı kondu. Cerrahi debridmanı takiben 21 gün süreyle yüksek doz Ampisilin + Sülbaktam tedavisi ile kür sağlandı. Actinomycosis her ne kadar ekstremitelerde, yumuşak doku ya da kemikte nadir görülse de; uzun süredir iyileşmeyen deri lezyonlarında akla mutlaka getirilmeli ve biyopsi işleminden kaçınılmamalıdır

Anahtar Kelimeler

• Aktinomikozis,el yerleşim,yumuşak doku

PRIMARY ACTINOMYCOSIS OF HAND: RARE LOCATION OF THIS ENTITY CASE REPORT

Abstract

Actinomycosis is chronic suppurative granulomatous infection that caused by an endogenous, gram-positive bacteria which named actinomyces. Actinomycosis have been reported at head, neck, thorax and abdomen, frequently. Placement on hand, subcutaneous tissue and bone is rare. The patient that 54 years old and male, referred on our hospital because of the presence of the lesion on his hand for five years Actinomycosis was diagnosed by determination of basophilic sulfur granules that surrounded by neutrophils and gram-positive, acid-fast negative filamentous bacilli in the granules at the histopathologic examination of the tissue biopsy. The patient treated by Ampicillin + Sulbactam for 21 days, after the surgical debridement. Although Actinomycosis is rarely seen at extremities, soft tissue and bone; it should be considered and not avoid of taking a biopsy from skin lesions that not healed for a long time. Key-words: Actinomycosis, hand localisation, soft tissue

References

1. ) Aliağaoğlu C, Albayrak H, Yıldırım U, Göksugur N, Özçelik D, Primer Cutaneus Actinomycosis in diabetic patients, Turkish Journal of Geriatrics 2011; 14: 377-80.
2. ) Mert A, Bilir M, Bahar H, Torun M, Tabak F, Oztürk R, Ozaras R, Aktuğlu Y, Primary Actinomycosis of the Hand A Case Report and Literature Review, International Diseases, 2001;5: of
3. Infectious 3) Yang C H, Primary Cutaneous Actinomycosis of An Extremity, A Case Report, J Intern Med Taiwan 2010; 21: 290-3.
4. ) Metgud SC, Case Report Primary cutaneous actinomycosis, a rare soft tissue infection, Indian Journal of Medical Microbiology, 2008;26
5. ) Golsha R, Najafi L, Rezaei Shirazi R, Vakilinejhad M, Mortazavi B, Roshandel G, Actinomycosis may be presentes in unusual organs, a case report of two cases , Journal of Clinical and Diagnostic Research, 2009 ;3:1938-41.
6. ) Tekin R, Gem M, Karakaya Y A, Boşnak V, Kapukkaya A, Primary Actinomycosis of the Knee and Ankle Joint An Unusual Manifestation, J Bacteriol Parasitol 2012; 3:3
7. )Musher DM, Actinomycosis of 54 Years’ Duration, Clin Infect Dis. 1998;27:889
8. ) Aypak C, Gökçe H, Altunsoy A, Koç S, Kaplan S, Primary actinomycosis of hand, A rare soft tissue infection, J Dermatol. 2012;39:741-2.

9. ) Fazeli M S, Bateni H, Actinomycosis, a rare soft tissue infection, Dermatology Online Journal 11: 18
10. ) McWilliams CA, Actinomycosis of phalax 1917;66:117-9. Ann