Machet L, Machet M C, Estève E, Delarbre J M, Pelucio-Lopes C, Pruvost F, Lorette G
Service de Dermatologie, Hôpital Trousseau, Tours.
Ann Dermatol Venereol. 1993;120(12):896-9.
Infections due to Actinomycosis species are located in the cervico-facial region in 50 to 65 percent of the cases. Extra-cervical cutaneous lesions are exceptional. The most frequently encountered germ is Actinomyces israeli, observed in 85 percent of the cases. We report the case of an Actinomyces meyeri infection which presented as a leg abscess and a pulmonary lesion. There was no cervico-facial localization. There was however a chronic parodontitis. A second germ, Capnocytophaga sp. was isolated from the abscess. This case is of particular interest because of the extracervical localization and the rare species isolated (17 other cases of Actinomyces meyeri infection have been reported). The mechanism of the infection can be better understood in light of pulmonary lesions in the lower right lobe due to inhalation and the coexistence of a buccodental germ in the culture of the leg abscess: buccodental origin of the germ, pulmonary lesion secondary to inhalation, septicaemic dissemination with cutaneous metastases.
放线菌属感染病例中,50%至65%位于颈面部区域。宫颈外皮肤病变罕见。最常遇到的病原体是以色列放线菌,在85%的病例中可见。我们报告了一例迈耶放线菌感染病例,表现为腿部脓肿和肺部病变。无颈面部定位。然而,存在慢性牙周炎。从脓肿中分离出第二种病原体——嗜二氧化碳噬纤维菌属。该病例特别值得关注,因为其宫颈外定位以及分离出的罕见菌种(此前已报告17例迈耶放线菌感染病例)。鉴于右下叶肺部病变是由于吸入所致,且腿部脓肿培养物中存在口腔牙齿病菌,可更好地理解感染机制:病菌源自口腔牙齿,吸入继发肺部病变,经血行播散并出现皮肤转移。