Department of Internal Medicine and Infectious Diseases, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
Department of Medical Microbiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
Int J Infect Dis. 2019 Sep;86:55-56. doi: 10.1016/j.ijid.2019.06.029. Epub 2019 Jul 6.
Actinomyces infection is a tissue destructive, low-grade infection that often resembles malignancy. We report the case of a 70-year-old male with repeated, culture-negative urinary tract infections while intermittently catheterized. At presentation, the patient reported a new episode of urinary tract infection with white discharge in his urine. Transrectal ultrasonography showed two lesions in the prostate, suspect for prostate cancer. However, biopsy did not show cancer, and anaerobic culture grew Actinomyces neuii. A 3-month antibiotic course of amoxicillin eventually cured the infection. This is a case of prostatic soft tissue infection with A. neuii. It is important to consider Actinomyces infection in patients with a non-malignant prostatic mass. Although β-lactam antibiotics do not penetrate the prostate well, the Actinomyces infection was cured by prolonged amoxicillin treatment in this case. It is possible that the tissue damage enhanced the amoxicillin concentration in the infected prostate.
放线菌感染是一种组织破坏性、低度感染，常类似恶性肿瘤。我们报告一例 70 岁男性，反复发生培养阴性的尿路感染，同时间歇性导尿。就诊时，患者诉尿路新感染，尿液中有白色分泌物。经直肠超声检查显示前列腺有两个病变，疑似前列腺癌。然而，活检未显示癌症，厌氧菌培养出纽氏放线菌。3 个月的阿莫西林抗生素疗程最终治愈了感染。这是一例前列腺软组织感染合并 A. neuii。对于非恶性前列腺肿块的患者，应考虑放线菌感染。虽然β-内酰胺类抗生素不易穿透前列腺，但在本例中，延长阿莫西林治疗治愈了放线菌感染。可能是组织损伤增强了感染前列腺中的阿莫西林浓度。
