Læknablaðið - 15.05.2010, Page 16

FRÆÐIGREINAR
RANNSÓKNIR
Þakkir
Bestu þakkir fá Haraldur Sigurðsson, sérfræðingur
í augnlækningum, og Ragnar Freyr Ingvarsson,
læknir í sérnámi í lyflækningum. Þá fær Ólafur
Skúli Indriðason nýrnalæknir bestu þakkir fyrir
tölfræðilega aðstoð. Einnig þökkum við Trausta
Óskarssyni lækni, Ástu Bragadóttur lækni, Karli
Kristinssyni læknanema, Helgu Erlendsdóttur
lífeindafræðingi og Önnu Atladóttur ritara fyrir
ýmsa aðstoð. Þeir læknar sem gáfu upplýsingar
um sína sjúklinga í tengslum við rannsóknina fá
bestu þakkir.
Heimildir
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Diseases 6th ed.: Churchill Livingstone, New York 2005:
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over a 36-year period. A diagnostic ,failure' with good
prognosis after treatment. Arch Intern Med 1975; 135:1562-8.
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M. Geislagerlabólga í sjötugri konu með gleymda lykkju.
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11. Laxdal Þ. Actinomycosis - fjögur tilfelli af Barnadeild
Landakotsspítala. Læknablaðið 1978: fylgirit 5: 68-76.
12. Bergþórsdóttir R, Benediktsdóttir KR, Þorsteinsson SB,
Baldursson Ó. Endobronchial actinomycosis secondary to a
tooth aspiration. Scand J Infect Dis 2004; 36: 384-6.
13. Baldursdóttir E, Sigurðsson H, Jónasson L, Gottfreðsson M.
Actinomycotic canaliculitis: resolution following surgery
and short topical antibiotic treatment. Acta Ophthalmol
2010; 88: 366-70.
14. Demant E, Hurwitz JJ. Canaliculitis: review of 12 cases. Can
J Ophthalmol 1980; 15: 73-5.
15. Briscoe D, Edelstein E, Zacharopoulos I, et al. Actinomyces
canaliculitis: diagnosis of a masquerading disease. Graefes
Arch Clin Exp Ophthalmol 2004; 242: 682-6.
16. Pine L, Hardin H, Turner L. Actinomycotic lacrimal
canaliculitis. Am J Opthalmol 1960; 49:1278-88.
17. Baik JJ, Lee GL, Yoo CG, Han SK, Shim YS, Kim YW.
Pulmonary actinomycosis in Korea. Respirology 1999; 4:
31-5.
18. Deshmukh N, Heaney SJ. Actinomycosis at multiple colonic
sites. Am J Gastroenterol 1986; 81:1212-4.
19. Grimes DA. Intrauterine device and upper-genital-tract
infection. Lancet 2000; 356:1013-9.
20. Fiorino AS. Intrauterine contraceptive device-associated
actinomycotic abscess and Actinomyces detection on
cervical smear. Obstet Gynecol 1996; 87:142-9.
21. Marella VK, Hakimian O, Wise GJ, Silver DA. Pelvic
actinomycosis. Urologic perspective. Int Braz J Urol 2004; 30:
367-76.
22. Curtis EM, Pine L. Actinomyces in the vaginas of women
with and without intrauterine contraceptive devices. Am J
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israelii in the genital tract of women with and without intra-
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Microbiol Sci 1987; 4: 72-8.
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The many faces of Actinomycosis. Results from
a retrospective study in lceland, 1984-2007
Introduction: Actinomycosis is a rare infection caused by
Actinomyces spp. which are part of the oral, intestinal and
vaginal bacterial flora. It can invade tissue through mucosal
disruption and form abscesses which tend to be difficult to
treat and diagnose. This population-based study explores
the epidemiology and manifestations of actinomycosis in
lceland.
Methodology: All diagnosed cases of actinomycosis in
lceland 1984-2007 were identified by a computerised search
using ICD and SNOMED codes. Clinical information was
collected by chart review. The subjects were included in the
study if they fulfilled two out of five diagnostic criteria.
Results: 41 women and 25 men (mean age 45 years) met
the diagnostic criteria. The incidence rate during the first
half of the period was 0.86/year/100.000 and 1.17 during
the second half.The cervicofacial region (42%) was most
commonly affected, then the pelvis (32%), lacrimal duct
(14%), abdomen (11%) and thorax (2%). Diagnostic delay
was common. The longest delay from first symptoms to
diagnosis was 8-9 years (median 5 months) and it was
significantly shorter among patients with abdominal or
pelvic infections compared to infections of the lacrimal duct
(p=0.012). No significant difference was noted in diagnostic
delay between other groups and no patients died from the
infection.
Conclusion: This is the first population-based study of
actinomycosis. The incidence rate increases with age and
the time passing from first symptoms to diagnosis tends to
be long.
Baldursdottir E, Jonasson L, Gottfredsson M.
The many faces of Actinomycosis. Results from a retrospective study in lceland, 1984-2007. Icel Med J 2010; 96: 323-8.
Key words: Actinomycosis, actinomyces, population based study, diagnostic delay.
Correspondence; Magnús Gottfreðsson, magnusgo@landspitali.is
328 LÆKNAblaðið 2010/96
Barst: 21. desember 2009, - samþykkt til birtingar: 11. mars 2010
Hagsmunatengsl: Engin