Actinomycosis

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Actinomycosis (ak-ti-no-my-co-sis, from the Greek aktis, meaning ray, mykes, meaning fungus, and -osis, meaning condition) is a rare, chronic, and slowly progressive infectious disease caused by bacteria in the Actinomyces genus, primarily Actinomyces israelii.

Definition

Actinomycosis is a granulomatous infection that typically forms abscesses and can lead to fibrosis and scarring. It is characterized by the formation of painful swellings in the neck, lungs, and gastrointestinal tract, which can later break through the skin surface to form draining sinuses.

Etiology

The disease is caused by Actinomyces species, which are Gram-positive, anaerobic, or microaerophilic bacteria. The most common species involved in human infections is Actinomyces israelii. These bacteria are normal inhabitants of the mouth, throat, digestive tract, and female genital tract, and only become pathogenic when they breach the mucosal barrier due to trauma, surgery, or disease.

Symptoms

The symptoms of actinomycosis are variable and depend on the site of infection. They may include weight loss, fever, and night sweats, as well as specific symptoms related to the affected organ system. For example, in the most common form of the disease, orocervicofacial actinomycosis, symptoms may include jaw pain, tooth loss, and the presence of a hard, painful swelling on the face or neck that may eventually form a sinus tract that drains to the skin surface.

Diagnosis

Diagnosis of actinomycosis can be challenging due to its nonspecific symptoms and slow course. It is often mistaken for a malignancy or tuberculosis. Definitive diagnosis requires the isolation of Actinomyces species from a clinical specimen, such as pus from an abscess or tissue from a biopsy.

Treatment

The treatment of choice for actinomycosis is high-dose, long-term therapy with penicillin. In patients allergic to penicillin, tetracycline, erythromycin, or clindamycin can be used. Surgical intervention may be necessary to drain abscesses or remove diseased tissue.

Prognosis

With appropriate treatment, the prognosis for actinomycosis is generally good, although the disease can cause significant morbidity due to its tendency to form abscesses and cause tissue destruction.

See also

External links

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