Actinomyces: Difference between revisions
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Actinomyces
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− | == |
+ | == Background == |
+ | ===Microbiology=== |
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− | == Syndromes == |
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+ | *Molar tooth appearance of colonies |
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+ | *Often part of polymicrobial infections |
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+ | ==Clinical Manifestations== |
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+ | **Starts as mass or cold abscess in neck, jaw, or mouth |
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+ | **Can invade bone |
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+ | **Spreads contiguously |
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+ | *Often no systemic symptoms like fever |
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+ | *May have "sulfur granules" discharge |
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− | * Alternatives include [[ceftriaxone]], amox/clav |
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+ | *Alternatives include [[Is treated by::ceftriaxone]], [[Is treated by::clindamycin]], and [[Is treated by::doxycycline]] |
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+ | *May need surgery |
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{{DISPLAYTITLE:''Actinomyces'' species}} |
{{DISPLAYTITLE:''Actinomyces'' species}} |
Revision as of 16:16, 12 August 2020
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