Actinomyces: Difference between revisions

Latest revision as of 17:16, 6 July 2022

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

Endocarditis

Management

First-line is penicillin IV x4-6 weeks then penicillin PO x6-12 months
Alternatives include ceftriaxone, clindamycin, and doxycycline
May need surgery

@@ Line 1: / Line 1: @@
+==Background==
-= Actinomyces =
-== Microbiology ==
+===Microbiology===
-* Weakly Gram-positive bacterium that looks fungal under microscopy
+*Weakly [[Stain::Gram-positive]] branching [[Shape::bacillus]] that looks fungal under microscopy
+*Molar tooth appearance of colonies
-* Oral and gut flora
+*Member of oral and gut flora
-* Spreads by direct invasion through tissue and creating fistulae
+*Often part of polymicrobial infections
+*Spreads by direct invasion through tissue and creating fistulae
+==Clinical Manifestations==
-== Syndromes ==
-=== Cervicofacial actinomycosis ===
+===Cervicofacial Actinomycosis===
-* &quot;Lumpy jaw syndrome&quot; with painless jaw mass, trismus, and eventually pain
+*"Lumpy jaw syndrome" with painless jaw mass, trismus, and eventually pain
+**Starts as mass or cold abscess in neck, jaw, or mouth
-* Most common form, accounting for ~50% of cases
+**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 ===
+===Abdominal Actinomycosis===
-* Presents as an abdominal mass that fistulizes to skin
+*Presents as an abdominal mass that fistulizes to skin
-=== Pulmonary actinomycosis ===
+===Pulmonary Actinomycosis===
-* Presents as a chronic, non-resolving pneumonia or as a lung cancer
+*Presents as a chronic, non-resolving [[pneumonia]] or as a lung cancer
-* Can spread directly to involve heart as well
+*Can spread directly to involve heart as well
-=== Others ===
+===Others===
-* Endocarditis
+*[[Endocarditis]]
-== Management ==
+==Management==
-* IV penicillin x4-6 weeks then PO penicillin x6-12 months
+*First-line is [[Is treated by::penicillin]] IV x4-6 weeks then [[penicillin]] PO x6-12 months
-* Alternatives include ceftriaxone, amox/clav
+*Alternatives include [[Is treated by::ceftriaxone]], [[Is treated by::clindamycin]], and [[Is treated by::doxycycline]]
+*May need surgery
+== Further Reading ==
+* ''Actinomyces'' and Related Organisms in Human Infections. doi: [https://journals.asm.org/doi/10.1128/CMR.00100-14 https://doi.org/10.1128/CMR.00100-14]{{DISPLAYTITLE:''Actinomyces''}}
+[[Category:Bacteria]]