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Actinomycosis

Actinomycosis. Definition: Is a chronic infection, commonly involves head and Neck region. Produces open Sinuses and abscess formation. Causes and risk factors . . Five types have been described; A.Israeli,A.bovis,A.viscosus,A.naeslun-dii, A.odontolyticus.

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Actinomycosis

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  1. Actinomycosis

  2. Definition: • Is a chronic infection, commonly involves head and Neck region. • Produces open Sinuses and abscess formation.

  3. Causes and risk factors. . Five types have been described; A.Israeli,A.bovis,A.viscosus,A.naeslun-dii, A.odontolyticus. • Normally non pathogenic in the nose and throat. • It causes infection when introduced into the facial tissues by trauma, dental procedures etc. • May cause hard abscess and nodule formation; the lumpy jaw. • Except for bovis all are normal flora of the oral cavity.

  4. Incidence: • Slight male preponderance.(1.5-1 to 3:1) • Usually 4th to 6th decade. • Can be divided into three distinct forms; Cervicofacial(50%),pulmonothoracic(30%) and abdominopelvic forms(20%).

  5. Characteristics: • They are gram+ve rods. • Anaerobes • Branching and filamentous in morphology.

  6. can also sometime cause pulmonary Actinomycosis. • Poor hygiene, dental abscess, alcohol abuse may result in pulmonary actinomycosis. • Causes lung cavities ,nodules and pleural effusions.

  7. The Cervicofacial type; • Fever • Hard tender lumps with or without open sinuses mostly in and around the mandibular region • Sulfur granules in the abscess. (sulfur granules can be seen in nocardia infections but those are acid fast) • Wt. loss • Rarely with cervical lymphadenopathy. .

  8. Actinomycosis(lumpy Jaw)

  9. Pulmonothoracic type: • Poor hygiene, dental abscess, alcohol abuse may result in pulmonary actinomycosis. • Causes lung cavities ,nodules and pleural effusions.

  10. Diagnosis: • Clinical findings. • Gram stain. • Culture. (poor growth in culture only in less than 50% of cases.) Sulphur granules (yellowish myecelial masses) • Specimens – open biopsy, aspiration material • The discharge should mix with sterile saline in a universal bottle and allow to stand, particles will separate out.

  11. Causes granulomatous inflammation, like chronic abscess of the neck, appendix • Yellow granules in the discharge

  12. Place between 2 slides • Crush and gram stain • Gram positive branching filaments

  13. Complications: • Osteomyelitis(although not common). • Otitis media. • Meningitis. • Lung infections. • Laryngeal infections(rare0

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