{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:20:52Z","timestamp":1790630452084,"version":"4.1.0"},"reference-count":22,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,11]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>A 45-year-old- man presented with left chest wall pain, swelling and cough. Over a 2-month period he developed abscesses in the right foot, right anterior thigh, left buttock and left chest. Incision and drainage of the soft tissue abscesses and video-assisted thoracoscopic surgery to drain the loculated empyema contiguous with the chest wall abscess were performed as surgical management. Gram stain showed beaded Gram-positive rods and the culture initially grew <jats:italic>Aggregatibacter actinomycetemcomitans and Eikenella corrodens<\/jats:italic>. Pathological evaluation of the pleura showed sulfur granules and organisms consistent with <jats:italic>Actinomyces spp.<\/jats:italic> on Gomori methenamine silver stain; <jats:italic>Actinomyces israelii<\/jats:italic> was recovered in culture with extended incubation. The patient was treated for 3 weeks with ceftriaxone and oral metronidazole, followed by oral amoxicillin. Culture of <jats:italic>A. actinomycetemcomitans<\/jats:italic> with other findings consistent with actinomycosis warrants 6\u201312 months of antibiotic therapy.<\/jats:p>","DOI":"10.1136\/bcr-2019-230287","type":"journal-article","created":{"date-parts":[[2019,9,24]],"date-time":"2019-09-24T11:45:10Z","timestamp":1569325510000},"page":"e230287","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Mixed <i>Actinomyces israelii<\/i> and <i>Aggregatibacter actinomycetemcomitans<\/i> infection causing empyema necessitatis and multiple skin abscesses in an immunocompetent patient"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4643-4798","authenticated-orcid":false,"given":"Takaaki","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgeny","family":"Arshava","sequence":"additional","affiliation":[{"name":"Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Ford","sequence":"additional","affiliation":[{"name":"Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poorani","family":"Sekar","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,9,24]]},"reference":[{"key":"2025082703503089000_12.9.e230287.1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/11.1.46"},{"key":"2025082703503089000_12.9.e230287.2","doi-asserted-by":"publisher","DOI":"10.1099\/ijs.0.64207-0"},{"key":"2025082703503089000_12.9.e230287.3","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.med.48.1.25"},{"key":"2025082703503089000_12.9.e230287.4","doi-asserted-by":"crossref","unstructured":"Storms I , van den Brand M , Schneeberger P , et al . 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