Background
Microbiology
- Weakly Gram-positive branching bacillus that looks fungal under microscopy
- Molar tooth appearance of colonies
- Member of oral and gut flora
- Often part of polymicrobial infections
- Spreads by direct invasion through tissue and creating fistulae
Clinical Manifestations
Cervicofacial Actinomycosis
- "Lumpy jaw syndrome" with painless jaw mass, trismus, and eventually pain
- Starts as mass or cold abscess in neck, jaw, or mouth
- Can invade bone
- Spreads contiguously
- Often no systemic symptoms like fever
- May have "sulfur granules" discharge
- Most common form, accounting for ~50% of cases
Abdominal Actinomycosis
- Presents as an abdominal mass that fistulizes to skin
Pulmonary Actinomycosis
- Presents as a chronic, non-resolving pneumonia or as a lung cancer
- Can spread directly to involve heart as well
Others
Management
Further Reading
