{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:25:47Z","timestamp":1709771147010},"reference-count":45,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Actinomycosis is an uncommon infection caused by <jats:italic>Actinomyces<\/jats:italic> species, and the diagnosis is often challenging owing to low prevalence and diverse clinical manifestations. Pericardial involvement of actinomycosis is particularly rare. Here, we present a case of a 79-year-old man who initially complained of exertional dyspnea, orthopnea, and decreased urine amount. There was no fever, chest pain, or productive cough. Physical examination was remarkable for decreased breath sounds at the left lower lung field. Poor dental hygiene and a firm, well-defined mass without discharge over the hard palate were noted. Echocardiography revealed reduced ejection fraction of the left ventricle, global hypokinesia, and thickened pericardium (&gt; 5\u2009mm) with a small amount of pericardial effusion. On admission, the patient underwent diagnostic thoracentesis, and the results suggested an exudate. However, bacterial and fungal cultures were all negative. There was no malignant cell by cytology. Computed tomography revealed contrast-enhanced pericardial nodular masses. Video-assisted thoracoscopic pericardial biopsy was performed. Histopathology confirmed actinomycosis with chronic abscess formation, and a tissue culture yielded <jats:italic>Aggregatibacter actinomycetemcomitans<\/jats:italic>. The symptoms resolved with administration of clindamycin for 6 months. This case highlights the challenge in the diagnosis of cardiac actinomycosis, the potential role of concomitant microorganisms as diagnostic clues, and the favorable clinical response achieved with appropriate antibiotic treatment.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0618","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T13:46:57Z","timestamp":1706708817000},"page":"504-508","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Pericardial Actinomycosis in a 79-Year-Old Man with Poor Dental Hygiene"],"prefix":"10.4269","volume":"110","author":[{"given":"Chun-Hsun","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzong-Yow","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen-Liang","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hsinchu Branch, Hsinchu, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wang-Da","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;"},{"name":"Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jann-Tay","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;"},{"name":"Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin-Shing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;"},{"name":"Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Lwun","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Laryngoscope","first-page":"1198","article-title":"Actinomycosis: diagnostic and therapeutic considerations and a review of 32 cases","volume":"94","author":"Bennhoff","year":"1984"},{"key":"b2","series-title":"Medicine (Baltimore)","first-page":"e3923","article-title":"Clinical features of actinomycosis: a retrospective, multicenter study of 28 cases of miscellaneous presentations","volume":"95","author":"Bonnefond","year":"2016"},{"key":"b3","series-title":"Int J Infect Dis","first-page":"358","article-title":"Actinomycosis: a great pretender. 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