SHM Converge Scientific Abstract ePoster Gallery-Actinomyces Odontolyticus Infection Mimicking Lymphoma in a Young Woman

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A 33-year-old woman with alcohol use, rheumatoid arthritis, and recent dental extraction presented with abdominal pain, fevers, night sweats, weight loss, and nonproductive cough. Initial labs showed leukopenia, transaminitis, and elevated lipase. CT chest/abdomen/pelvis revealed widespread lymphadenopathy and new bilateral upper-lobe cavitary lung lesions, raising concern for lymphoma, infection, or autoimmune disease.<br /><br />Extensive work-up was unrevealing: blood, fungal, and AFB cultures were negative; flow cytometry and peripheral smear showed no malignancy; ANA, ANCA, RF, anti-CCP, EBV PCR, HIV, ACE, and IgG4 were all negative or normal. Bartonella serologies were equivocal. Because of persistent diagnostic uncertainty, the patient was managed with infectious disease, hematology, and pulmonology input. Bronchoscopy with bronchoalveolar lavage grew Actinomyces odontolyticus, and cytology was negative for malignancy. Axillary lymph node biopsy showed reactive granulomatous inflammation consistent with infection.<br /><br />She was treated with IV penicillin G followed by oral Augmentin. After two months, follow-up imaging showed complete resolution of the cavitary lung lesions and lymphadenopathy.<br /><br />This case highlights Actinomyces odontolyticus as an emerging cause of thoracic infection that can closely mimic lymphoma and other inflammatory or infectious disorders. Diagnosis may be difficult because cultures are often negative; pathology and Gram stain can be more sensitive. Risk factors include dental disease, alcohol use, malignancy, and immunosuppression. Prompt multidisciplinary evaluation is essential to avoid delayed diagnosis, unnecessary procedures, and increased morbidity.

Asset Subtitle

Minisha Lohani

Meta Tag

Author List Cristina E. Marti Amarista, Emaan Alvi, Justin Passman, Minisha Lohani, Sadia Abbasi

Category Clinical Vignettes

Concept Actinomyces odontolyticus

Concept Thoracic infection

Concept Cavitary Lung Lesion

Concept Actinomycosis

Concept Penicillin

Distinguished Non-Finalist

Presenter Organization Stony Brook University Hospital

Presenting Author Minisha Lohani

Track Adult

Keywords

Actinomyces odontolyticus

cavitary lung lesions

lymphadenopathy

bronchoscopy

granulomatous inflammation

dental extraction

penicillin G

Augmentin

thoracic infection

lymphoma mimic

Actinomyces odontolyticus

Thoracic infection

Cavitary Lung Lesion

Actinomycosis

Penicillin