Actinomycosis

Definition

Definition of Actinomycosis
Actinomycosis is an infectious bacterial disease caused by Actinomyces species such as Actinomyces israelii or A. gerencseriae. It can also be caused by Propionibacterium propionicus, and the condition is likely to be polymicrobial.

Actinomycosis occurs rarely in humans but rather frequently in cattle as a disease called lumpy jaw. This name refers to the large abscesses that grow on the head and neck of the infected animal. It can also affect swine, horses, and dogs, and less often wild animals.

Symptoms

Symptoms of Actinomycosis
The disease is characterized by the formation of painful abscesses in the mouth, lungs, or gastrointestinal tract. Actinomycosis abscesses grow larger as the disease progresses, often over months. In severe cases, they may penetrate the surrounding bone and muscle to the skin, where they break open and leak large amounts of pus. The purulent leakage via the sinus cavities contains "sulfur granules," not actually sulfur-containing but resembling such particles. These granules contain progeny bacteria.

Causes

Causes of Actinomycosis
Actinomycosis GRAM'SActinomycosis is primarily caused by any of several members of the bacterial genus Actinomyces. These bacteria are generally anaerobes. In animals, they normally live in the small spaces between the teeth and gums, causing infection only when they can multiply freely in anoxic environments. An affected human often has recently had dental work, poor oral hygiene, periodontal disease, or radiation therapy causing local tissue damage to the oral mucosa, all of which predispose the person to developing actinomycosis. They are also normal commensals in the caecum; thus, abdominal actinomycosis can occur following removal of the appendix. The three most common sites of infection are decayed teeth, the lungs, and the intestines. It is important to note that actinomycosis does not occur in isolation from other bacteria. This infection depends on other bacteria (gram positive, gram negative, and cocci) to aid in invasion of tissue.

Diagnosis

Diagnosis of Actinomycosis
Actinomycosis may be hard to diagnose at onset. There are lab tests that may isolate actinomyces in pus or tissue specimens.

Prognosis

Prognosis of Actinomycosis
With treatment, you should recover fully.

Treatment

Treatment of Actinomycosis
Actinomyces bacteria are generally sensitive to penicillin, which is frequently used to treat actinomycosis. In cases of penicillin allergy, doxycyclin is used. Sulfonamides such as sulfamethoxazole may be used as an alternative regimen at a total daily dosage of 2-4 grams. Response to therapy is slow and may take months.

Prevention

Prevention of Actinomycosis
Good oral hygiene and regular dentist visits may help prevent some forms of actinomycosis.