Actinomycosis

What is actinomycosis?

Actinomycosis is a chronic or slowly progressive infection caused by various bacterial species of Actinomyces gender, most commonly Actinomyces israelii. Actinomyces are normal inhabitants of the mouth, gastrointestinal tract, and female genital tract, and do not cause infection unless there is a break in the skin or mucous membrane. Actinomyces It also seems to require the presence of other companions bacteria to cause disease.

The disease is characterized by the formation of a abscess and draining breast tracts (small tunnels that open onto the skin's surface or mucous membranes and drainage pus). Drain pus contains yellow granules called sulfur granules. These are named after the color of the granules, not their content.

Actinomycosis is being differentiated of actinomycetoma, which is a chronic infection of the skin and subcutaneous tissue, which generally affects the foot (see myoma). Actinomycetoma is caused by different Actinomyces species found in soil and plant material in tropical regions.

Who is at risk for actinomycosis?

Actinomycosis is relatively rare, but the following factors increase the risk of infection:

• Poor oral hygiene followed by dental surgery or trauma
• Impaired immunity, for example, immunosuppressive drugs or chronic conditions such as diabetes mellitus.
• Malnutrition
• Residence in tropical countries

What are the clinical features of actinomycosis?

Cervicofacial actinomycosis

Cervicofacial actinomycosis (neck and head) is the most common form of infection, accounting for 50-70% of cases. Dental surgery, oral or facial trauma, or local tissue damage caused by Cancer or radiation therapy It commonly precedes infection. The infection usually begins with a slow, progressive, painless, hard lump on the cheek or around the jaw. This evolves into abscesses and sinus drains. The surrounding tissues swell. Fever and other symptoms of systemic The infection is sometimes present. Actinomycosis around the jaw can cause trismus (prolonged spasm of the jaw muscles).

Lymph nodes they generally do not enlarge and there is usually little pain, unless adjacent The structures are compressed. The infection slowly spreads to surrounding tissues and organs, such as the scalp, eyes, ears, tongue, larynxand trachea. Invasion of the adjacent bone occasionally occurs. The infection can spread to the meninges (the membranes that surround the brain and spinal column) cable) causing meningitis.

Abdominal actinomycosis

Abdominal disease (10-20% of cases) usually follows a rupture in the gastrointestinal mucosa, for example, after surgery, appendicitis, diverticulitis, or ingestion foreign bodies such as chicken or fish bones. This disease is difficult to diagnose since patients often have nonspecific symptoms of slow progression, such as fever, weight loss, diarrhea or constipation, and abdominal pain. Any abdominal organ can be affected by the direct spread of the disease. Sinus tracts are occasionally found spreading to the skin of the abdominal wall or the mucous membrane tissue of the rectum or anus.

Pulmonary actinomycosis

Lung disease (15-20% of cases) is usually caused by aspiration (inhalation) of oral or gastrointestinal secretions. The infection presents with slowly progressive nonspecific symptoms such as cough, sputum production, breathing difficulties and chest pain. The infection can spread slowly to involve local structures such as the heart and chest wall, with sinus tracts occasionally spreading to the skin of the chest.

Pelvic actinomycosis

Pelvic actinomycosis is rare and is associated with the use of intrauterine contraceptive devices Common symptoms of this infection include discomfort in the lower abdomen, abnormal vaginal and vaginal bleeding. download.

Primary cutaneous actinomycosis

Primary cutaneous actinomycosis is very rare and affects exposed skin after the direct implantation of the organism during an injury

How is actinomycosis diagnosed?

• Material obtained from the aspiration of an abscess or sinus tract, or of a biopsy the sample can be grown in the laboratory; Strict growing conditions are required to grow Actinomyces. A variety of accompanying bacteria will often be present.
• Sulfur granules can be examined under a microscope to detect characteristic features of Actinomyces; However, this is not conclusive proof, like other bacterium Called Nocardia it has a similar appearance.

What is the treatment for actinomycosis?

The goal of actinomycosis treatment is to treat the infection with large doses of antibiotics and surgery to create an unfavorable disease. aerobic conditions for the growth of Actinomyces species.

• Actinomycosis is treated with antibiotics, such as penicillin. High doses of intravenous penicillin followed by oral penicillin are generally needed to penetrate areas of fibrosis and suppuration Prolonged treatment is often required to prevent relapse.
• Alternative antibiotics include tetracyclines, erythromycin, and clindamycin.
• Surgical management includes drainage of deep abscesses, excision of sinus tract and elimination of infected bulky masses.
• The combined treatment of penicillin and surgery almost always produces a cure.