Actinomycosis

• A. Israelii – the commonest• A .Meyeri• A.Naeslundii• A.Odontolyticus• A. Viscosus

Actinomycosis

ACTINOMYCOSISNot highly virulent (Opportunist)– Component of Oral Flora• Periodontal pockets• Dental plaque• Tonsilar crypts

– Take advantage of injury to penetrate mucosal barriers• Coincident infection• Trauma• Surgery

• The smears revealed radiating filamentous colonies of Actinomyces in a background of neutrophilic exudates; PAS stain also showed Actinomyces colonies.

Dr.T.V.Rao MD 8

Typical appearance of histopathological examination with special stains

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People at risk with actinomycosis

• Having a dental disease or recent dental surgery (for jaw abscess)

• Aspiration (liquids or solids are sucked into lungs) (for lung abscess)

• Having bowel surgery (for abdominal abscess)• Swallowing fragments of chicken or other bones (for

abdominal abscess)• For women: having an intrauterine contraceptive device

(IUD) in place for many years (for abscess affecting the reproductive organs)

Dr.T.V.Rao MD 10

Cervicofacial Actinomycosis

• This is the most common and recognized presentation of the disease.

• Actinomyces species are commonly present in high concentrations in tonsillar crypts and gingivodental crevices. Many patients have a history of poor dentition, oral surgery or dental procedures, or trauma to the oral cavity.

• Chronic tonsillitis, mastoiditis, and otitis are also important risk factors for actinomycosis.

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Infection Cervicofacial region

• Periostitis or osteomyelitis can develop if the infection extends to facial and maxillary bones. The mandible appears to be one of the most common osteomyelitis sites.

Abdominal Actinomycosis

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Examination of discharges will help in diagnosis

• Examination of drained fluid under a microscope shows "sulphur granules" in the fluid. They are yellowish granules made of clumped organisms

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Mycetoma • Mycetoma is a chronic subcutaneous

infection caused by actinomycetes or fungi. • This infection results in a

granulomatous inflammatory response in the deep dermis and subcutaneous tissue, which can extend to the underlying bone.

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Mycetoma • Mycetoma is characterized by the

formation of grains containing aggregates of the causative organisms that may be discharged onto the skin surface through multiple sinuses.

• Mycetoma was first described in the mid 1800s and initially named Madura foot, after the region of Madura in India where the disease was first identified.