Successful Antimicrobial Therapy of Esophageal Stenosis Because of Actinomycosis

Esophageal stenosis can cause vomiting or dysphagia in children and is commonly treated with esophageal balloon dilation. However, surgery may be required if the stenosis does not respond to dilation. Although esophageal actinomycosis can cause severe esophageal strictures and be refractory to ballo...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2024-05, Vol.153 (5)
Main Authors: Yokoyama, Shinichiro, Hashimoto, Satsuki, Nishibori, Shigeki, Hamada, Hiromi, Nui, Akihiro, Kimura, Sachiko
Format: Article
Language:English
Subjects:
Actinomycosis
Actinomycosis - complications
Actinomycosis - diagnosis
Actinomycosis - drug therapy
Amoxicillin
Amoxicillin - administration & dosage
Amoxicillin - therapeutic use
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - therapeutic use
Antimicrobial agents
Balloon treatment
Child, Preschool
Children
Dysphagia
Esophageal Stenosis - drug therapy
Esophageal Stenosis - etiology
Esophagus
Humans
Male
Patients
Penicillin
Penicillin G - administration & dosage
Penicillin G - therapeutic use
Stenosis
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Summary:Esophageal stenosis can cause vomiting or dysphagia in children and is commonly treated with esophageal balloon dilation. However, surgery may be required if the stenosis does not respond to dilation. Although esophageal actinomycosis can cause severe esophageal strictures and be refractory to balloon dilation, it has been reported to respond effectively to antimicrobial therapy in adults. However, the course of the disease and appropriate treatment strategies in children are not well understood. We present a case of a previously healthy 2-year-old boy diagnosed with esophageal stenosis because of actinomycosis. The patient was treated with intravenous penicillin G, followed by oral amoxicillin for 8 weeks and 6 months, respectively. After completion of the antimicrobial treatment, the patient showed improvement in symptoms and endoscopic findings. At the 1-year follow-up, the patient showed consistent weight gain and normal growth without further intervention. This case highlights the importance of considering esophageal actinomycosis as a potential cause of esophageal stenosis in children and the potential effectiveness of antimicrobial therapy in avoiding surgical intervention.
ISSN:0031-4005
1098-4275
1098-4275
DOI:10.1542/peds.2023-062823