Esophagitis Due to Actinomycosis in a Previously Immunocompetent Patient with a History of Steroids Treatment for Sars-COV-2 Infection: A Case Report

Abstract

We present an unusual case of esophageal actinomycosis that was developed in a previously inmunocompetent patient with transitory inmunosuppresion originated for receiving steroids for SARS-CoV-2 infection treatment.  Esophageal actinomycosis is a very rare entity in immunocompetent patients. It presents with subacute course and usually responds poorly to antibiotics, with frequent develop-ment of local complications, such as esophagotracheal fistula.

We report a case of a 56-year-old female patient without chronic degenerative pathologies with a history of non-severe acute Sars-CoV-2 infection that  occurred two months prior to her presentation, treated with prednisone and betamethasone orally and inhaled respectively for 21 days. The pivotal symptom is dysphagia and to get to the definitive diagnosis requires a tissue culture of the affected organ or a biopsy revealing the classic sulphur granules. Currently, antibiotic treatment with beta-lactams, such as amoxicillin/clavulanic acid, is still effective, as it was in our patient. Antibiotic treatment with beta-lactams, such as amoxicillin/clavulanic acid, is still effective, as it was in our patient, who had a significant improvement by removing symptoms.