Actinomycosis

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A patient with Actinomycosis of the face

Actinomyces infections are rare infections, involving the head and neck, abdominal cavity, and the lung. Actinomycosis infections are subacute to chronic infection caused by the gram-positive filamentous non-acid fast anaerobic to microaerophilic bacteria, Actinomyces. The infection is usually a granulomatous and suppurative infection. The chronic form has multiple abscesses that form sinus tracts and are associated with sulfur granules. About 70% of infections are due to either Actinomyces israelii or Actinomyces gerencseriae. The diagnosis can be difficult, as isolation of the organism requires prolonged bacterial culture under anaerobic conditions.

Diagnosis

The diagnosis was confirmed by the polymerase chain reaction technique.

Treatment

Treatment is with a combination of ampicillin and surgical decortication.

Difficult to diagnose

Due to their rarity, Actinomyces infections are not often suspected. These infections are difficult to diagnose due to specific microbiologic requirements for isolation of Actinomyces.

Causative organism

The infection is usually polymicrobial and very rarely spreads hematogenously. The other organisms which are usually associated with the infection are Aggregatibacter actinomycetemcomitans, Prevotella, Streptococcus, Enterobacteriaceae, Peptostreptococcus, and Staphylococcus. A-Z index of infectious diseases | Glossary of infection control | Glossary of vaccines

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