Actinomyces & Nocardia

1. Actinomyces & Nocardia

2. Actinomyces • A.israelii, A.naeslundii; • Gram positive; sulfur granule; • Related to decay tooth and peridentitis

3. ACTINOMYCES Anaerobic, filamentous, gram positive bacillus • Exhibit true branching • “Mykes” – Greek for “fungus” • Thought by early microbiologist to be fungi because of: • Morphology • Disease they cause

4. Clinical specimens:Actinomycosis-pus

5. Actinomycosis

6. Not 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 ACTINOMYCOSIS

7. Actinomycosis • A chronic suppurative and granulomatous肉芽肿disease of the cervico-facial, thoracic or abdominal areas

8. ACTINOMYCOSIS Form indurated masses with fibrous walls and central loculations with pus • Pus contains "Sulfur Granules" • Gritty, yellow white • Average diameter - 2mm • Composed of mineralized “mycelial” mass Chronic infection • Form burrowing sinus tracts to skin or mucus membranes • Discharge purulent material

9. Actinomycosis - sulfur granule

10. Pulmonary Actinomycosis • 15% of cases • Aspiration of organism from the oropaharynx • Slowly progressive process involving lung and pleura • May be mistaken for malignancy • Chest pain, fever, wgt loss and hemoptysis

11. Mycetoma(足菌病） Streptomyces species?

12. Nocardiosis • Subcutaneous infections, pulmonary infections, and brain abscesses • N. asteroides; N. brasiliensis

15. Lab. Diagnosis • Clinical Specimens:Sputum,Pus,Biopsy tissue

16. Sulfamethoxazole-Trimethoprim