RESUMO
We report a 77-year-old man with a skin abscess caused by Actinomyces radingae. Targeted antibiotic therapy with amoxicillin/clavulanic acid for 6 weeks resulted in clearing of the infection. A. radingae is a rare pathogenic agent of skin and soft tissue infections. As with other Actinomyces infections, the early identification of the pathogen and specific antibiotic therapy is crucial for successful resolution of the infection because of the chronic course and the long treatment time needed. Usually, A. radingae is sensitive to ßlactam antibiotics.
Assuntos
Abscesso , Actinomyces , Actinomicose , Antibacterianos , Dermatopatias Bacterianas , Humanos , Masculino , Idoso , Abscesso/microbiologia , Abscesso/tratamento farmacológico , Abscesso/diagnóstico , Actinomicose/tratamento farmacológico , Actinomicose/diagnóstico , Actinomicose/microbiologia , Actinomicose/patologia , Actinomyces/isolamento & purificação , Antibacterianos/uso terapêutico , Dermatopatias Bacterianas/microbiologia , Dermatopatias Bacterianas/tratamento farmacológico , Dermatopatias Bacterianas/diagnóstico , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Resultado do TratamentoRESUMO
The immune response to mycobacteria is characterized by granuloma formation, which features multinucleated giant cells as a unique macrophage type. We previously found that multinucleated giant cells result from Toll-like receptor-induced DNA damage and cell autonomous cell cycle modifications. However, the giant cell progenitor identity remained unclear. Here, we show that the giant cell-forming potential is a particular trait of monocyte progenitors. Common monocyte progenitors potently produce cytokines in response to mycobacteria and their immune-active molecules. In addition, common monocyte progenitors accumulate cholesterol and lipids, which are prerequisites for giant cell transformation. Inducible monocyte progenitors are so far undescribed circulating common monocyte progenitor descendants with high giant cell-forming potential. Monocyte progenitors are induced in mycobacterial infections and localize to granulomas. Accordingly, they exhibit important immunological functions in mycobacterial infections. Moreover, their signature trait of high cholesterol metabolism may be piggy-backed by mycobacteria to create a permissive niche.
Assuntos
Citocinas/imunologia , Células Gigantes/imunologia , Macrófagos/imunologia , Monócitos/imunologia , Células-Tronco/imunologia , Animais , Células Cultivadas , Citocinas/metabolismo , Feminino , Células Gigantes/metabolismo , Células Gigantes/microbiologia , Granuloma/imunologia , Granuloma/metabolismo , Humanos , Macrófagos/metabolismo , Macrófagos/microbiologia , Camundongos da Linhagem 129 , Camundongos Endogâmicos C57BL , Camundongos Knockout , Camundongos Transgênicos , Monócitos/metabolismo , Monócitos/microbiologia , Mycobacterium/imunologia , Mycobacterium/fisiologia , Células-Tronco/metabolismo , Células-Tronco/microbiologiaRESUMO
Discussion on how antibiotic treatment routes Mycobacterium avium to phagolysosomes without eliciting an immune response in human macrophages.