Actinomyces: Difference between revisions
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Actinomyces
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+ | ==Background== |
===Microbiology=== |
===Microbiology=== |
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==Clinical Manifestations== |
==Clinical Manifestations== |
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− | ===Cervicofacial |
+ | ===Cervicofacial Actinomycosis=== |
*"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=== |
*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=== |
*Presents as a chronic, non-resolving [[pneumonia]] or as a lung cancer |
*Presents as a chronic, non-resolving [[pneumonia]] or as a lung cancer |
Revision as of 12:30, 11 April 2021
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