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World Journal of Case Reports and Clinical Images
World Journal of Case Reports and Clinical Images
A Case Report | Open Access
Volume 2025 - 4 | Article ID 266 | http://dx.doi.org/10.51521/WJCRCI.2025.e41.411
Academic Editor: John Bose
Chesney
Skaggs, M.D.
Chesney Skaggs, M.D., University of
Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
Corresponding
Author: Chesney Skaggs, M.D., University of Arkansas for
Medical Sciences Northwest, Fayetteville, Arkansas
Citation:
Chesney Skaggs, (2025) Delayed Diagnosis of Esophageal Actinomycosis: A Case
Report. World J Case Rep Clin Imag. 2025 June; 4(1)1-5.
Copyrights:
© Chesney Skaggs, 2025, This article is licensed under the Creative Commons
Attribution-Non Commercial-4.0-International-License-(CCBY-NC)
(https://worldjournalofcasereports.org/blogpage/copyright-policy). Usage and
distribution for commercial purposes require written permission.
Abstract
Actinomycosis is an uncommon bacterial
infection caused by the Actinomyces species. While these bacteria are part of
the normal human flora, infection can occur after injury to the mucosal barrier
in the setting of certain risk factors. Actinomycosis may involve multiple
sites with a variety of presentations requiring a high index of suspicion for
diagnosis. We report the case of a 69-year-old female with stage IV breast
cancer presenting with odynophagia and epigastric pain.
Esophagogastroduodenoscopy (EGD) was remarkable for Grade D esophagitis and a
malignant-appearing esophageal stenosis. Histopathology revealed colonies of
Actinomyces spp, initially thought to be an incidental finding. Subsequently,
the patient was hospitalized with worsening esophageal symptoms and associated
weight loss. CT chest showed mid-esophageal wall thickening with surrounding
mediastinal attenuation. Given her clinical picture and prior EGD findings,
treatment for esophageal actinomycosis with IV penicillin G was initiated.
After one month, the patient was transitioned to oral antibiotics and completed
a six-month course for actinomycosis with resolution of symptoms. This case
highlights a rare presentation of esophageal actinomycosis and the importance
of early recognition and treatment.
Keywords:
Actinomycosis, esophageal actinomycosis, odynophagia, dysphagia, esophagitis.
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