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Hin mörgu andlit geislagerlabólgu : faraldsfræðileg rannsókn á Íslandi 1984-2007

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Authors
Eyrún Baldursdóttir
Lárus Jónasson
Magnús Gottfreðsson
Issue Date
2010-05-01

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Other Titles
The many faces of Actinomycosis. Results from a retrospective study in Iceland, 1984-2007
Citation
Læknablaðið 2010, 96(5):323-8
Abstract
INTRODUCTION: Actinomycosis is a rare infection caused by Actinomyces spp. which are part of the oral, intestinal and vaginal bacterial flora. It can invade tissue through mucosal disruption and form abscesses which tend to be difficult to treat and diagnose. This population-based study explores the epidemiology and manifestations of actinomycosis in Iceland. METHODOLOGY: All diagnosed cases of actinomycosis in Iceland 1984-2007 were identified by a computerised search using ICD and SNOMED codes. Clinical information was collected by chart review. The subjects were included in the study if they fulfilled two out of five diagnostic criteria. RESULTS: 41 women and 25 men (mean age 45 years) met the diagnostic criteria. The incidence rate during the first half of the period was 0.86/year/100.000 and 1.17 during the second half.The cervicofacial region (42%) was most commonly affected, then the pelvis (32%), lacrimal duct (14%), abdomen (11%) and thorax (2%). Diagnostic delay was common. The longest delay from first symptoms to diagnosis was 8-9 years (median 5 months) and it was significantly shorter among patients with abdominal or pelvic infections compared to infections of the lacrimal duct (p=0.012). No significant difference was noted in diagnostic delay between other groups and no patients died from the infection. CONCLUSION: This is the first population-based study of actinomycosis. The incidence rate increases with age and the time passing from first symptoms to diagnosis tends to be long.
Inngangur: Geislagerlabólga (actinomycosis) er fátíð sýking sem orsakast af Actinomyces spp. sem lifa gistilífi í örveruflóru munnhols, meltingarvegar og æxlunarfæra kvenna. Sýklarnir geta við rof á slímhúð komist í dýpri vefi og valdið ígerðum sem torvelt er að greina og meðhöndla. Markmiðið var að kanna faraldsfræði og birtingarmynd sýkingarinnar á Íslandi. Efniviður og aðferðir: Gerð var afturvirk rannsókn á geislagerlabólgu greindri 1984-2007 á Íslandi. Leitað var eftir ICD-greiningarkóðum og vefjasýnum með viðeigandi SNOMED-númerum. Klínískar upplýsingar fengust úr sjúkraskrám. Greiningarskilmerki í fimm liðum voru sett fram og þurftu sjúklingar að uppfylla tvö þeirra. Niðurstöður: Greiningarskilmerki uppfylltu 41 kona og 25 karlar, meðalaldur 45 ár. Nýgengi fyrri helming tímabilsins var 0,86/ár/100.000 en 1,17 á þeim seinni. Algengasti sýkingarstaður var höfuð og andlit (42%), grindarhol (32%), táragöng (14%), kviðarhol (11%) og brjósthol (2%). Greiningartöf var algeng, lengst liðu 8-9 ár frá fyrstu einkenn-um að greiningu (miðgildi 5 mánuðir) og var hún styttri hjá sjúklingum með sýkingu í grindar- eða kviðarholi en sýkingu í táragöngum (p=0,012). Enginn munur var á greiningartöf milli annarra hópa og enginn lést vegna sýkingarinnar. Ályktun: Þetta er fyrsta lýðgrundaða rannsóknin á geislagerlabólgu. Nýgengi eykst með hækkandi aldri og tími frá fyrstu einkennum að greiningu er oft langur.
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