Giannakodimos Ilias, Ziogou Afroditi, Giannakodimos Alexios, Mitakidi Evangelia, Kaltsas Aris, Kratiras Zisis, Chrisofos Michael
Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 124 62 Athens, Greece.
Department of Medical Oncology, Metaxa Cancer Hospital, 185 37 Athens, Greece.
Microorganisms. 2024 Sep 21;12(9):1922. doi: 10.3390/microorganisms12091922.
Actinomycosis of the kidney is extremely rare, with only a few cases reported in the literature. This rare entity usually presents with common clinical manifestations and non-specific imaging findings, thus rendering its diagnosis extremely challenging. According to case reports published in the literature, fever was present in the majority of cases (56.25%). Several risk factors have been related to the development of renal actinomycosis, including a history of urogenital surgery, urolithiasis, or urogenital cancer. Initial diagnostic investigation consists of abdominal ultrasonography (15 patients, 46.88%) and abdominal computed tomography (23 patients, 48.15%). Regarding therapeutic approach, 5 patients (16.67%) received only antibiotic treatment, 5 patients (16.67%) underwent surgery, and 20 patients (66.67%) received both antibiotic and surgical treatment. Accurate diagnosis relies on the clinician's high index of suspicion and is ultimately confirmed through histological examination or cultures, obtained either preoperatively via biopsies or postoperatively after surgical removal of the infected kidney. To our knowledge, this is the first narrative review of the literature that collects knowledge concerning infection of UUT induced by dysbiosis of actinomycosis species. The aim of this narrative review was to systematically search the literature on primary renal actinomycosis, highlighting the diagnostic approach and treatment strategies for the management of this rare entity.
肾放线菌病极为罕见，文献中仅报道了少数病例。这种罕见疾病通常表现出常见的临床表现和非特异性影像学表现，因此其诊断极具挑战性。根据文献发表的病例报告，大多数病例（56.25%）出现发热症状。肾放线菌病的发生与多种危险因素有关，包括泌尿生殖系统手术史、尿路结石或泌尿生殖系统癌症。初步诊断检查包括腹部超声检查（15例患者，46.88%）和腹部计算机断层扫描（23例患者，48.15%）。在治疗方法方面，5例患者（16.67%）仅接受了抗生素治疗，5例患者（16.67%）接受了手术治疗，20例患者（66.67%）接受了抗生素和手术联合治疗。准确的诊断依赖于临床医生的高度怀疑指数，并最终通过组织学检查或培养来确诊，培养样本可在术前通过活检获取，或在术后通过手术切除受感染的肾脏获得。据我们所知，这是第一篇对相关文献的叙述性综述，收集了有关放线菌物种生态失调引起的上尿路（UUT）感染的知识。本叙述性综述的目的是系统检索关于原发性肾放线菌病的文献，突出这种罕见疾病的诊断方法和治疗策略。
