Journal Article

A case of recurrent acute cholecystitis caused by Actinomyces odontolyticus, rare actinomycosis

Kyohei Sugiyama, Kento Furuya, Hideyuki Kanemoto, Akitsugu Fujita, Kenta Ito, Toshio Shimada

2022

Overview

Backgrounds Actinomyces species are gram-positive, obligate anaerobic rods and are rare causes of cholecystitis. Because Actinomyces species are anaerobic bacteria, it is difficult for Actinomyces to survive in bile apart from A. naeslundii. We experienced a case of recurrent acute cholecystitis caused by A. odontolyticus. Case presentation A patient had been diagnosed with acute cholecystitis and treated one month before and after that, admitted to our hospital because of recurrent cholecystitis. Gram stain of the bile revealed gram-positive rods and gram-positive cocci. We found A. odontolyticus and MRSA in bile culture and MRSA in blood culture. We administered piperacillin-tazobactam and then changed it to ampicillin-sulbactam and vancomycin. The patient underwent laparoscopic cholecystectomy and was discharged safely. Conclusions To our knowledge, this is the first case of cholecystitis caused by A. odontolyticus . Cholecystitis caused by Actinomyces species is rare. In addition, we may overlook it with the low positivity of bile cultures of Actinomyces . Whenever the cholecystitis recurs without any obstruction of the biliary tract, we should search for the gram-positive rods hidden in the bile, such as A. odontolyticus, as the causative organism, even if the bile culture is negative.

• Publisher: Springer Science and Business Media LLC,BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Abdomen / Abscesses / Actinomyces / Actinomyces odontolyticus / Actinomycosis / Actinomycosis - diagnosis / Actinomycosis - drug therapy / Actinomycosis - microbiology / Ampicillin / Ampicillin/sulbactam / Anaerobic bacteria / Antibiotics / Bile / Biliary tract / Blood / Blood culture / Case Report / Case studies / Causes of / Cholangitis / Cholecystectomy / Cholecystitis / Cholecystitis - diagnosis / Cholecystitis - microbiology / Cholecystitis - surgery / Cholecystitis, Acute / Cholecystitis, Acute - diagnosis / Cholecystitis, Acute - surgery / Complications and side effects / Diseases / Drug resistance / Gallbladder / Gallbladder diseases / Gram stain / Gram-positive cocci / Hospitalization / Humans / Infectious and parasitic diseases / Infectious Diseases / Internal Medicine / Laparoscopy / Liver / Medical Microbiology / Medicine / Medicine & Public Health / Parasitology / Pathogens / Patients / Penicillin / Piperacillin / Piperacillin-tazobactam / Rare species / RC109-216 / Relapse / Rods / Staphylococcus infections / Sulbactam / Tazobactam / Tropical Medicine / Vancomycin