Actinomycosis: Difference between revisions

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'''For patient information click [[Actinomycosis(patient information)|here]]'''
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = {{PAGENAME}} |
   Name          = Actinomycosis |
   Image          = Actinomycosis.jpg |
   Image          = Actinomycosis.jpg |
   Caption        = A patient with Actinomycosis on the right side of the face. |
   Caption        = A patient with Actinomycosis on the right side of the face. |
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   OMIM          = |
   OMIM          = |
   MedlinePlus    = |
   MedlinePlus    = |
  eMedicineSubj  = med |
  eMedicineTopic = 31 |
   MeshID        = D000196 |
   MeshID        = D000196 |
}}
}}
{{SI}}
__NOTOC__
{{CMG}}
{{Actinomycosis}}
{{About1|Actinomyces israelii}}
 
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


==Overview==
{{CMG}};{{AE}}{{ADG}}
[[Image:Actinomycosis_2.jpg|thumb|left|A BHI plate culture of Actinomyces sp., strain X616, at 72hrs of growth]]
'''Actinomycosis''' ''(ak-tuh-nuh-my-KOH-sihs)'', is a rare [[infectious disease|infectious]] [[bacteria]]l disease of humans generally caused by ''Actinomyces israelii'', ''A. gerencseriae'' and ''Propionibacterium propionicus'', though the condition is likely to be polymicrobial.<ref name=Baron>{{cite book | author = Bowden GHW | title = Actinomycosis ''in:'' Baron's Medical Microbiology ''(Baron S ''et al'', eds.)| edition = 4th ed. | publisher = Univ of Texas Medical Branch | year = 1996 | id = [http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.1883 (via NCBI Bookshelf)] ISBN 0-9631172-1-1 }}</ref> Characterized by the formation of painful [[abscess]]es in the [[mouth]], [[lungs]], or digestive organs, actinomycosis abscesses grow larger as the disease progresses, often over a period of months. In severe cases, the abscesses may penetrate the surrounding bone and muscle to the skin, where they break open and leak large amounts of pus.


Actinomycosis occurs in cattle and other animals as a disease called ''lumpy jaw''. This name refers to the large abscesses that grow on the head and neck of the infected animal.
{{SK}} Actinomyces infection; Actinomyces israelii infection; Lumpy jaw;


In 1877 [[pathologist]] [[Otto Bollinger]] described the presence of ''Actinomyces bovis'' in cattle, and shortly afterwards, James Israel discovered ''Actinomyces israelii'' in humans. In 1890 [[Eugen Bostroem]] isolated the causative organism from a culture of grain, grasses, and soil. After Bostroem's discovery there was a general misconception that actinomycosis was a [[mycosis]] that affected individuals who chewed grass or straw.
==[[Actinomycosis overview|Overview]]==


==Causative organism==
==[[Actinomycosis historical perspective|Historical Perspective]]==
Actinomycosis is primarily caused by any of several members of the bacterial [[genus]] ''[[Actinomyces]]''. These bacteria are generally [[Anaerobic organism|anaerobes]].<ref name=Sherris>{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0838585299 }}</ref> ''Actinomyces'' spp. normally live in the small spaces between the teeth and gums, causing infection only when they can multiply freely in anoxic environments. The three most common sites of infection are decayed teeth, the lungs, and the [[intestines]].


Since ''Actinomyces'' bacteria are generally sensitive to [[penicillin]], it is frequently used to treat actinomycosis.
==[[Actinomycosis classification|Classification]]==


== Pathophysiology & Etiology==  
==[[Actinomycosis pathophysiology|Pathophysiology]]==


* 6 species cause disease in humans:
==[[Actinomycosis causes|Causes]]==
*:* ''A. israelii''
*:* ''A. Naeslundii''
*:* ''A. odontolyticus''
*:* ''A. viscosus''
*:* ''A. Meyeri''
*:* ''A. gerencseriae''
* Gram positive filamentous rod
* Sulfur Granules
* Actinomyces from within, Nocardia from without
* Generally low pathogenicity and cause disease only in the setting of antecedent tissue injury


==[[Actinomycosis differential diagnosis|Differentiating Actinomycosis from other Diseases]]==


== Symptoms ==
==[[Actinomycosis epidemiology and demographics|Epidemiology and Demographics]]==
* Cervicofacial Actinomycosis (55%)
*:* Acute painful [[pyogenic]] [[abscess]] or indolent angle-of-jaw mass
* Thoracic Actinomycosis  
*:* [[Lungs]]
*:* [[Pleura]]
*:* [[Mediastinum]]
*:* Chest wall ([[aspiration]], extension of cervicofacial disease, transdiaphragmatic or retroperitoneal spread)
*:*:* Clinical picture of  [[tuberculosis]] (TB) or [[malignancy]]
* [[Abdominal]] and [[Pelvic]] Actinomycosis
*:* Following:
*:*:* Penetrating [[trauma]]
*:*:* [[Gut perforation]]
*:*:* [[Surgical]] manipulation
*:* [[Ileocecal]] predilection
*:*:* Confused with:
*:*:*:* [[TB]]
*:*:*:* Ameboma
*:*:*:* Chronic appy
*:*:*:* [[Regional enteritis]]
*:*:*:* [[Carcinoma]]
*:*:*:* [[Intrauterine devices]] (IUD’s)
* [[Central Nervous System]] (CNS)
*:* [[Brain abscess]]
*:* [[Meningitis]]
*:* [[Meningoencephalitis]]
*:* [[Subdural empyema]]


== Pharmacotherapy ==
==[[Actinomycosis risk factors|Risk Factors]]==


* In vitro susceptible to:
==[[Actinomycosis screening|Screening]]==
*:* [[Penicillin]]
*:* [[Chloramphenicol]]
*:* The [[tetracycline]]s
*:* [[Erythromycin]]
*:* [[Clindamycin]]
*:* [[Imipenem]]
*:* [[Streptomycin]]
*:* The [[cephalosporin]]s
*:*:* Prolonged treatment (6-12 months)


== Surgery and Device Based Therapy ==
==[[Actinomycosis natural history|Natural History, Complications and Prognosis]]==
* [[Surgery]] often required for disease of the [[chest]], [[abdomen]], [[pelvis]], and [[central nervous system]] (CNS)


==References==
==Diagnosis==
<div class="references-small"><references/></div>
[[Actinomycosis history and symptoms|History and Symptoms]] | [[Actinomycosis physical examination|Physical Examination]] | [[Actinomycosis laboratory tests|Laboratory Findings]] | [[Actinomycosis electrocardiogram|Electrocardiogram]]  | [[Actinomycosis chest x ray|X Ray]] | [[Actinomycosis CT|CT]] | [[Actinomycosis MRI|MRI]] | [[Actinomycosis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Actinomycosis other imaging findings|Other Imaging Findings]] | [[Actinomycosis other diagnostic studies|Other Diagnostic Studies]]


==External links==
==Treatment==
* [http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijid/vol6n1/actino.xml Journal of Infectious Diseases, Actinomycosis of the Tongue]
[[Actinomycosis medical therapy|Medical therapy]] | [[Actinomycosis surgery|Surgery]] | [[Actinomycosis primary prevention|Primary Prevention]]  | [[Actinomycosis secondary prevention|Secondary Prevention]] | [[Actinomycosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Actinomycosis future or investigational therapies|Future or Investigational Therapies]]


== Acknowledgements ==
== Acknowledgements ==
The content on this page was first contributed by: Dr. Steve Wiviott  
The content on this page was first contributed by: Dr. Steve Wiviott  


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[[pl:Promienica]]
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[[ro:Actinomicoza]]
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[[Category:Bacterial diseases]]
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Latest revision as of 16:16, 18 September 2017

Actinomycosis
A patient with Actinomycosis on the right side of the face.
ICD-10 A42
ICD-9 039
DiseasesDB 145
MeSH D000196

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This page is about clinical aspects of the disease.  For microbiologic aspects of the causative organism(s), see Actinomyces israelii.

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Synonyms and keywords: Actinomyces infection; Actinomyces israelii infection; Lumpy jaw;

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Actinomycosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Acknowledgements

The content on this page was first contributed by: Dr. Steve Wiviott

Template:Bacterial diseases

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