Primary actinomycosis of the big toe: a case report and literature review

Author:

Almarzouq Sawsan F1,Almarghoub Mohammed A2,Almeshal Obaid3

Affiliation:

1. Plastic and Reconstructive Surgery Division, Department of General Surgery, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia

2. Plastic and Reconstructive Surgery Section, Department of Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

3. Department of Plastic Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia

Abstract

Abstract Actinomyces are Gram-positive branching bacteria that are part of the human gastrointestinal microflora. These organisms can cause actinomycosis, which is a slowly progressive suppurative infection involving the cervicofacial region. Primary involvement of extremities is very rare. Here, we present primary actinomycosis of the lower extremity and a review of related literature. A 35-year-old female from Al-Kharj City (agricultural area) presented to our plastic surgery clinic with complaints of a large mass on the left big toe that caused embarrassment and difficulty in wearing footwear. The patient underwent wide local excision and coverage of the big toe defect with Kutler bilateral V-Y advancement flaps. A high index of suspicion is required to diagnose actinomycosis in subacute or chronic inflammatory soft tissue lesions. Proper surgical intervention and antimicrobial are essential to treat the disease. We conclude that a high index of suspicion is required to diagnose actinomycosis in subacute or chronic inflammatory soft tissue lesions.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference12 articles.

1. Actinomycosis: diagnostic and therapeutic considerations and a review of 32 cases;Bennhoff;Laryngoscope,1984

2. Primary actinomycosis of an extremity: a case report and review;Reiner;Rev Infect Dis,1987

3. Primary cutaneous Actinomycosis of an extremity: a case report;Ching-Huei;J Int Med Taiwan,2010

4. Primary cutaneous actinomycosis of lower extremity: a rare case report;Hossain;AKMMC J,2015

5. Primary cutaneous actinomycosis of the lower extremity: a clinical dilemma;Sonam;J Orthop Surg Rehabil,2017

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