Primary mammary actinomycosis challenged with penicillin allergy

BMJ Case Rep. 2021 Jul 13;14(7):e235883. doi: 10.1136/bcr-2020-235883.

Abstract

Actinomycosis is a subacute-to-chronic bacterial infection caused by gram-positive, filamentous, non-acid-fast, facultative anaerobic bacteria. It is a normal commensal bacterium found in the oral cavity and the lower reproductive tract of women. We present a case of primary actinomycosis of the breast. A postmenopausal woman, complicated by penicillin allergy, presented with a left breast lump clinically simulating malignancy. The first line of treatment for actinomycosis is penicillin. Due to a penicillin allergy, the patient was initially treated with doxycycline. However, doxycycline was discontinued due to tremors, and was replaced by clindamycin. The patient had a good clinical response with resolution of the abscess.

Keywords: breast cancer; drugs: infectious diseases; general practice / family medicine; general surgery; ultrasonography.

Publication types

  • Case Reports

MeSH terms

  • Actinomycosis* / diagnosis
  • Actinomycosis* / drug therapy
  • Anti-Bacterial Agents / adverse effects
  • Clindamycin
  • Drug Hypersensitivity* / diagnosis
  • Drug Hypersensitivity* / drug therapy
  • Drug Hypersensitivity* / etiology
  • Female
  • Humans
  • Penicillins / adverse effects

Substances

  • Anti-Bacterial Agents
  • Penicillins
  • Clindamycin