Actinomyces: Difference between revisions
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Actinomyces
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==Background== |
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===Microbiology=== |
===Microbiology=== |
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*Weakly [[Stain::Gram-positive]] branching [[ |
*Weakly [[Stain::Gram-positive]] branching [[Shape::bacillus]] that looks fungal under microscopy |
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*Molar tooth appearance of colonies |
*Molar tooth appearance of colonies |
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*Member of oral and gut flora |
*Member of oral and gut flora |
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==Clinical Manifestations== |
==Clinical Manifestations== |
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===Cervicofacial |
===Cervicofacial Actinomycosis=== |
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*"Lumpy jaw syndrome" with painless jaw mass, trismus, and eventually pain |
*"Lumpy jaw syndrome" with painless jaw mass, trismus, and eventually pain |
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*Most common form, accounting for ~50% of cases |
*Most common form, accounting for ~50% of cases |
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===Abdominal |
===Abdominal Actinomycosis=== |
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*Presents as an abdominal mass that fistulizes to skin |
*Presents as an abdominal mass that fistulizes to skin |
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===Pulmonary |
===Pulmonary Actinomycosis=== |
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*Presents as a chronic, non-resolving [[pneumonia]] or as a lung cancer |
*Presents as a chronic, non-resolving [[pneumonia]] or as a lung cancer |
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*May need surgery |
*May need surgery |
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== Further Reading == |
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{{DISPLAYTITLE:''Actinomyces'' species}} |
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* ''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''}} |
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[[Category:Bacteria]] |
[[Category:Bacteria]] |
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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
Management
- First-line is penicillin IV x4-6 weeks then penicillin PO x6-12 months
- Alternatives include ceftriaxone, clindamycin, and doxycycline
- May need surgery
Further Reading
- Actinomyces and Related Organisms in Human Infections. doi: https://doi.org/10.1128/CMR.00100-14
