ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Bennhoff DF , 1984. Actinomycosis: diagnostic and therapeutic considerations and a review of 32 cases. Laryngoscope 94: 1198–1217.
-
2.
Bonnefond S , Catroux M , Melenotte C , Karkowski L , Rolland L , Trouillier S , Raffray L , 2016. Clinical features of actinomycosis: a retrospective, multicenter study of 28 cases of miscellaneous presentations. Medicine (Baltimore) 95: e3923.
-
3.
Acevedo F , Baudrand R , Letelier LM , Gaete P , 2008. Actinomycosis: a great pretender. Case reports of unusual presentations and a review of the literature. Int J Infect Dis 12: 358–362.
-
4.
Valour F et al., 2014. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management. Infect Drug Resist 7: 183–197.
-
5.
Wong VK , Turmezei TD , Weston VC , 2011. Actinomycosis. BMJ 343: d6099.
-
6.
Hussein MR , 2008. Mucocutaneous Splendore-Hoeppli phenomenon. J Cutan Pathol 35: 979–988.
-
7.
Klinger R , 1912. Untersuchungen uber menschliche aktinomycose. Zentralbl Bakteriol Orig 62: 191–200.
-
8.
Nørskov-Lauritsen N , Claesson R , Birkeholm Jensen A , Åberg CH , Haubek D , 2019. Aggregatibacter actinomycetemcomitans: clinical significance of a pathobiont subjected to ample changes in classification and nomenclature. Pathogens 8: 243.
-
9.
Kaplan AH , Weber DJ , Oddone EZ , Perfect JR , 1989. Infection due to Actinobacillus actinomycetemcomitans: 15 cases and review. Rev Infect Dis 11: 46–63.
-
10.
Kobayashi T , Arshava E , Ford B , Sekar P , 2019. Mixed Actinomyces israelii and Aggregatibacter actinomycetemcomitans infection causing empyema necessitatis and multiple skin abscesses in an immunocompetent patient. BMJ Case Rep 12: e2302387.
-
11.
Cornell A , Shookhoff HB , 1944. Actinomycosis of the heart simulating rheumatic fever: report of three cases of cardiac actinomycosis, with a review of the literature. Arch Intern Med 74: 11–27.
-
12.
Pulverer G , Schütt-Gerowitt H , Schaal KP , 2003. Human cervicofacial actinomycoses: microbiological data for 1997 cases. Clin Infect Dis 37: 490–497.
-
13.
Jánoskuti L , Lengyel M , Fenyvesi T , 2004. Cardiac actinomycosis in a patient presenting with acute cardiac tamponade and a mass mimicking pericardial tumour. Heart 90: e27.
-
14.
Fife TD , Finegold SM , Grennan T , 1991. Pericardial actinomycosis: case report and review. Rev Infect Dis 13: 120–126.
-
15.
Ioannou P , Baliou S , Papakitsou I , Kofteridis DP , 2023. Infective endocarditis by Actinomyces species: a systematic review. J Chemother 35: 87–94.
-
16.
Llenas-García J , Lalueza-Blanco A , Fernández-Ruiz M , Villar-Silva J , Ochoa M , Lozano F , Lizasoain M , Aguado J , 2012. Primary hepatic actinomycosis presenting as purulent pericarditis with cardiac tamponade. Infection 40: 339–341.
-
17.
Sakaguchi Y , Isowa N , Nakazaki H , Takeda K , Tokuyasu H , Saitoh Y , Soeda T , Ohe T , Tokuyasu Y , Miura H , 2012. Acute cardiac tamponade caused by the extension of multiple hepatic actinomycotic abscesses. Intern Med 51: 305–308.
-
18.
Cho E , Park SW , Jun CH , Shin SS , Park EK , Lee KS , Park SY , Park CH , Kim HS , Choi SK , 2018. A rare case of pericarditis and pleural empyema secondary to transdiaphragmatic extension of pyogenic liver abscess. BMC Infect Dis 18: 1–6.
-
19.
Olds KL , Gilbert JD , Byard RW , 2021. Actinomyces in forensic practice. Am J Forensic Med Pathol 42: 191–193.
-
20.
Esposti D , Lippolis A , Cipolla M , Bonazzi M , 2000. An uncommon cause of pericardial actinomycosis. Ital Heart J 1: 632–635.
-
21.
O’Sullivan RA , Armstrong JG , Rivers JT , Mitchell CA , 1991. Pulmonary actinomycosis complicated by effusive constrictive pericarditis. Aust N Z J Med 21: 879–880.
-
22.
Zijlstra E , Swart G , Godfroy F , Degener J , 1992. Pericarditis, pneumonia and brain abscess due to a combined Actinomyces – Actinobacillus actinomycetemcomitans infection. J Infect 25: 83–87.
-
23.
Shinagawa N , Yamaguchi E , Takahashi T , Nishimura M , 2002. Pulmonary actinomycosis followed by pericarditis and intractable pleuritis. Intern Med 41: 319–322.
-
24.
Beier KH , Rusnak RA , 1997. Unusual presentation of cervicothoracic actinomycosis complicated by pericardial effusion: a case report. J Emerg Med 15: 303–307.
-
25.
Kedmi M , Cohen-Poradosu R , Gilon D , Izhar U , Sviri S , 2007. Thoracic actinomycosis with extension of the infection to the pericardium and chest wall. Isr Med Assoc J 9: 490–491.
-
26.
Litwin KA , Jadbabaie F , Villanueva M , 1999. Case of pleuropericardial disease caused by Actinomyces odontolyticus that resulted in cardiac tamponade. Clin Infect Dis 29: 219–220.
-
27.
Peters GL , Davies RA , Veinot JP , Burwash IG , 2006. Cardiac actinomycosis: an unusual cause of an intracardiac mass. J Am Soc Echocardiogr 19: 1530.e7–1530.e11.
-
28.
Jitmuang A , 2008. Primary actinomycotic endocarditis: a case report and literature review. J Med Assoc Thai 91: 931.
-
29.
Makaryus AN , Latzman J , Yang R , Rosman D , 2005. A rare case of Actinomyces israelii presenting as pericarditis in a 75-year-old man. Cardiology 13: 125–127.
-
30.
Almutairi A , Cheema A , Joudeh A , Alqarni A , Albadr S , Alnaimi M , 2022. Pericardial mass: a rare form of cardiac actinomycosis case report. Ann Med Surg (Lond) 78: 103854.
-
31.
Nishizawa S , Anan K , Tobino K , Okahisa M , Goto Y , Murakami K , Sueyasu T , Munechika M , Yoshimine K , Yoshino M , 2018. Pulmonary actinomycosis attributable to Actinomyces meyeri presenting as cardiac tamponade: a case report. Multidiscip Respir Med 13: 1–5.
-
32.
Yamaji Y , Tobino K , Asaji M , Anan K , Yasuda Y , Tsuruno K , Ebi N , 2013. Cardiac tamponade and fatal arrhythmia caused by cardiac actinomycosis attributable to Actinomyces meyeri. Chest 144: 208A.
-
33.
Toom S , Xu Y , 2018. Hemolytic anemia due to native valve subacute endocarditis with Actinomyces israelii infection. Clin Case Rep 6: 376.
-
34.
Eng-Frost J , Murray L , Lorensini S , Harjit-Singh RS , 2022. Cardiac tamponade and constrictive pericarditis due to Actinomyces meyeri bacterial pericarditis: a case report. Eur Heart J Case Rep 6: ytac260.
-
35.
Korkchi N , Ngo L , Ranasinghe I , 2023. Pericardial infiltration and constriction due to cardiac actinomycosis: a case report. Heart Lung Circ 32: S298–S299.
-
36.
Saeed W , Adam M , Abdallah TA , Omrani AS , 2020. Percutaneous coronary intervention-associated Actinomyces oris. IDCases 22: e00929.
-
37.
Mack R , Slicker K , Ghamande S , Surani SR , 2014. Actinomyces odontolyticus: rare etiology for purulent pericarditis. Case Rep Med 2014: 734925.
-
38.
Reisinger A , Matzkies LM , Eller P , Fruhwald F , Krause R , 2019. Pericardial empyema due to Actinomyces israelii, Aggregatibacter actinomycetemcomitans, and Fusobacterium nucleatum. Pol Arch Intern Med 129: 714–715.
-
39.
Broly E , Risse J , Maschino F , Wahl D , 2016. Cardiac tamponade due to Actinomyces odontolyticus originating from a dentigerous cyst. J Oral Maxillofac Surg 74: 2453–2456.
-
40.
Kanna B , Soni A , 2002. Disseminated actinomycosis with unusual cardiac involvement: case report and review. Infect Dis Clin Pract 11: 408–413.
-
41.
Mahadevappa M , Kulkarni P , Poornima K , 2020. Disseminated actinomycosis presenting as chronic right-heart failure due to right ventricular and pericardial infiltration. Case Rep 2: 1992–1998.
-
42.
Yang W-T , Grant M , 2019. Actinomyces neuii: a case report of a rare cause of acute infective endocarditis and literature review. BMC Infect Dis 19: 1–7.
-
43.
Tuck N , Leatherman J , Assi M , Kallail KJ , 2021. A case of actinomycosis presenting as purulent pericarditis with cardiac tamponade. Kans J Med 14: 227.
-
44.
Choi J , Koh WJ , Kim TS , Lee KS , Han J , Kim H , Kwon OJ , 2005. Optimal duration of IV and oral antibiotics in the treatment of thoracic actinomycosis. Chest 128: 2211–2217.
-
45.
Sudhakar SS , Ross JJ , 2004. Short-term treatment of actinomycosis: two cases and a review. Clin Infect Dis 38: 444–447.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1775 | 1775 | 59 |
| Full Text Views | 41 | 41 | 0 |
| PDF Downloads | 56 | 56 | 0 |
Case Report: Pericardial Actinomycosis in a 79-Year-Old Man with Poor Dental Hygiene
Chun-Hsun Liao
Chun-Hsun Liao
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;
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Tzong-Yow Wu
Tzong-Yow Wu
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;
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Yen-Liang Lin
Yen-Liang Lin
Department of Internal Medicine, National Taiwan University Hsinchu Branch, Hsinchu, Taiwan;
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Wang-Da Liu
Wang-Da Liu
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;
Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan;
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Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan;
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Jann-Tay Wang
Jann-Tay Wang
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;
Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan;
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Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan;
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Jin-Shing Chen
Jin-Shing Chen
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;
Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
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Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
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Yi-Lwun Ho
Yi-Lwun Ho
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan;
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ABSTRACT.
Actinomycosis is an uncommon infection caused by Actinomyces 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 (> 5 mm) 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 Aggregatibacter actinomycetemcomitans. 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.
Author Notes
Authors’ addresses: Chun-Hsun Liao, Tzong-Yow Wu, and Yi-Lwun Ho, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, E-mails: b01401097@ntu.edu.tw, retep0102@gmail.com, and ylho@ntu.edu.tw. Yen-Liang Lin, Department of Internal Medicine, National Taiwan University Hsinchu Branch, Hsinchu, Taiwan, E-mail: b95401006@ntu.edu.tw. Wang-Da Liu, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, and Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan, E-mail: b95401043@ntu.edu.tw. Jann-Tay Wang, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, and Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan, E-mail: wang.jt1968@gmail.com. Jin-Shing Chen, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, and Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan, E-mail: chenjs@ntu.edu.tw.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Bennhoff DF , 1984. Actinomycosis: diagnostic and therapeutic considerations and a review of 32 cases. Laryngoscope 94: 1198–1217.
-
2.
Bonnefond S , Catroux M , Melenotte C , Karkowski L , Rolland L , Trouillier S , Raffray L , 2016. Clinical features of actinomycosis: a retrospective, multicenter study of 28 cases of miscellaneous presentations. Medicine (Baltimore) 95: e3923.
-
3.
Acevedo F , Baudrand R , Letelier LM , Gaete P , 2008. Actinomycosis: a great pretender. Case reports of unusual presentations and a review of the literature. Int J Infect Dis 12: 358–362.
-
4.
Valour F et al., 2014. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management. Infect Drug Resist 7: 183–197.
-
5.
Wong VK , Turmezei TD , Weston VC , 2011. Actinomycosis. BMJ 343: d6099.
-
6.
Hussein MR , 2008. Mucocutaneous Splendore-Hoeppli phenomenon. J Cutan Pathol 35: 979–988.
-
7.
Klinger R , 1912. Untersuchungen uber menschliche aktinomycose. Zentralbl Bakteriol Orig 62: 191–200.
-
8.
Nørskov-Lauritsen N , Claesson R , Birkeholm Jensen A , Åberg CH , Haubek D , 2019. Aggregatibacter actinomycetemcomitans: clinical significance of a pathobiont subjected to ample changes in classification and nomenclature. Pathogens 8: 243.
-
9.
Kaplan AH , Weber DJ , Oddone EZ , Perfect JR , 1989. Infection due to Actinobacillus actinomycetemcomitans: 15 cases and review. Rev Infect Dis 11: 46–63.
-
10.
Kobayashi T , Arshava E , Ford B , Sekar P , 2019. Mixed Actinomyces israelii and Aggregatibacter actinomycetemcomitans infection causing empyema necessitatis and multiple skin abscesses in an immunocompetent patient. BMJ Case Rep 12: e2302387.
-
11.
Cornell A , Shookhoff HB , 1944. Actinomycosis of the heart simulating rheumatic fever: report of three cases of cardiac actinomycosis, with a review of the literature. Arch Intern Med 74: 11–27.
-
12.
Pulverer G , Schütt-Gerowitt H , Schaal KP , 2003. Human cervicofacial actinomycoses: microbiological data for 1997 cases. Clin Infect Dis 37: 490–497.
-
13.
Jánoskuti L , Lengyel M , Fenyvesi T , 2004. Cardiac actinomycosis in a patient presenting with acute cardiac tamponade and a mass mimicking pericardial tumour. Heart 90: e27.
-
14.
Fife TD , Finegold SM , Grennan T , 1991. Pericardial actinomycosis: case report and review. Rev Infect Dis 13: 120–126.
-
15.
Ioannou P , Baliou S , Papakitsou I , Kofteridis DP , 2023. Infective endocarditis by Actinomyces species: a systematic review. J Chemother 35: 87–94.
-
16.
Llenas-García J , Lalueza-Blanco A , Fernández-Ruiz M , Villar-Silva J , Ochoa M , Lozano F , Lizasoain M , Aguado J , 2012. Primary hepatic actinomycosis presenting as purulent pericarditis with cardiac tamponade. Infection 40: 339–341.
-
17.
Sakaguchi Y , Isowa N , Nakazaki H , Takeda K , Tokuyasu H , Saitoh Y , Soeda T , Ohe T , Tokuyasu Y , Miura H , 2012. Acute cardiac tamponade caused by the extension of multiple hepatic actinomycotic abscesses. Intern Med 51: 305–308.
-
18.
Cho E , Park SW , Jun CH , Shin SS , Park EK , Lee KS , Park SY , Park CH , Kim HS , Choi SK , 2018. A rare case of pericarditis and pleural empyema secondary to transdiaphragmatic extension of pyogenic liver abscess. BMC Infect Dis 18: 1–6.
-
19.
Olds KL , Gilbert JD , Byard RW , 2021. Actinomyces in forensic practice. Am J Forensic Med Pathol 42: 191–193.
-
20.
Esposti D , Lippolis A , Cipolla M , Bonazzi M , 2000. An uncommon cause of pericardial actinomycosis. Ital Heart J 1: 632–635.
-
21.
O’Sullivan RA , Armstrong JG , Rivers JT , Mitchell CA , 1991. Pulmonary actinomycosis complicated by effusive constrictive pericarditis. Aust N Z J Med 21: 879–880.
-
22.
Zijlstra E , Swart G , Godfroy F , Degener J , 1992. Pericarditis, pneumonia and brain abscess due to a combined Actinomyces – Actinobacillus actinomycetemcomitans infection. J Infect 25: 83–87.
-
23.
Shinagawa N , Yamaguchi E , Takahashi T , Nishimura M , 2002. Pulmonary actinomycosis followed by pericarditis and intractable pleuritis. Intern Med 41: 319–322.
-
24.
Beier KH , Rusnak RA , 1997. Unusual presentation of cervicothoracic actinomycosis complicated by pericardial effusion: a case report. J Emerg Med 15: 303–307.
-
25.
Kedmi M , Cohen-Poradosu R , Gilon D , Izhar U , Sviri S , 2007. Thoracic actinomycosis with extension of the infection to the pericardium and chest wall. Isr Med Assoc J 9: 490–491.
-
26.
Litwin KA , Jadbabaie F , Villanueva M , 1999. Case of pleuropericardial disease caused by Actinomyces odontolyticus that resulted in cardiac tamponade. Clin Infect Dis 29: 219–220.
-
27.
Peters GL , Davies RA , Veinot JP , Burwash IG , 2006. Cardiac actinomycosis: an unusual cause of an intracardiac mass. J Am Soc Echocardiogr 19: 1530.e7–1530.e11.
-
28.
Jitmuang A , 2008. Primary actinomycotic endocarditis: a case report and literature review. J Med Assoc Thai 91: 931.
-
29.
Makaryus AN , Latzman J , Yang R , Rosman D , 2005. A rare case of Actinomyces israelii presenting as pericarditis in a 75-year-old man. Cardiology 13: 125–127.
-
30.
Almutairi A , Cheema A , Joudeh A , Alqarni A , Albadr S , Alnaimi M , 2022. Pericardial mass: a rare form of cardiac actinomycosis case report. Ann Med Surg (Lond) 78: 103854.
-
31.
Nishizawa S , Anan K , Tobino K , Okahisa M , Goto Y , Murakami K , Sueyasu T , Munechika M , Yoshimine K , Yoshino M , 2018. Pulmonary actinomycosis attributable to Actinomyces meyeri presenting as cardiac tamponade: a case report. Multidiscip Respir Med 13: 1–5.
-
32.
Yamaji Y , Tobino K , Asaji M , Anan K , Yasuda Y , Tsuruno K , Ebi N , 2013. Cardiac tamponade and fatal arrhythmia caused by cardiac actinomycosis attributable to Actinomyces meyeri. Chest 144: 208A.
-
33.
Toom S , Xu Y , 2018. Hemolytic anemia due to native valve subacute endocarditis with Actinomyces israelii infection. Clin Case Rep 6: 376.
-
34.
Eng-Frost J , Murray L , Lorensini S , Harjit-Singh RS , 2022. Cardiac tamponade and constrictive pericarditis due to Actinomyces meyeri bacterial pericarditis: a case report. Eur Heart J Case Rep 6: ytac260.
-
35.
Korkchi N , Ngo L , Ranasinghe I , 2023. Pericardial infiltration and constriction due to cardiac actinomycosis: a case report. Heart Lung Circ 32: S298–S299.
-
36.
Saeed W , Adam M , Abdallah TA , Omrani AS , 2020. Percutaneous coronary intervention-associated Actinomyces oris. IDCases 22: e00929.
-
37.
Mack R , Slicker K , Ghamande S , Surani SR , 2014. Actinomyces odontolyticus: rare etiology for purulent pericarditis. Case Rep Med 2014: 734925.
-
38.
Reisinger A , Matzkies LM , Eller P , Fruhwald F , Krause R , 2019. Pericardial empyema due to Actinomyces israelii, Aggregatibacter actinomycetemcomitans, and Fusobacterium nucleatum. Pol Arch Intern Med 129: 714–715.
-
39.
Broly E , Risse J , Maschino F , Wahl D , 2016. Cardiac tamponade due to Actinomyces odontolyticus originating from a dentigerous cyst. J Oral Maxillofac Surg 74: 2453–2456.
-
40.
Kanna B , Soni A , 2002. Disseminated actinomycosis with unusual cardiac involvement: case report and review. Infect Dis Clin Pract 11: 408–413.
-
41.
Mahadevappa M , Kulkarni P , Poornima K , 2020. Disseminated actinomycosis presenting as chronic right-heart failure due to right ventricular and pericardial infiltration. Case Rep 2: 1992–1998.
-
42.
Yang W-T , Grant M , 2019. Actinomyces neuii: a case report of a rare cause of acute infective endocarditis and literature review. BMC Infect Dis 19: 1–7.
-
43.
Tuck N , Leatherman J , Assi M , Kallail KJ , 2021. A case of actinomycosis presenting as purulent pericarditis with cardiac tamponade. Kans J Med 14: 227.
-
44.
Choi J , Koh WJ , Kim TS , Lee KS , Han J , Kim H , Kwon OJ , 2005. Optimal duration of IV and oral antibiotics in the treatment of thoracic actinomycosis. Chest 128: 2211–2217.
-
45.
Sudhakar SS , Ross JJ , 2004. Short-term treatment of actinomycosis: two cases and a review. Clin Infect Dis 38: 444–447.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1775 | 1775 | 59 |
| Full Text Views | 41 | 41 | 0 |
| PDF Downloads | 56 | 56 | 0 |