Actinomycosis pathophysiology: Difference between revisions

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Revision as of 14:23, 20 March 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pathophysiology

Actinomycosis is caused by the bacteria Actinomyces.

Transmission

Actinomyces are part of natural flora of human body,resides in the oral cavity, lower gastrointestinal tract and urogenital tract.
They are non virulent under normal conditions
When there is break in the mucosa, anywhere from the mouth to the rectum they reach tissues and cause damage.

Incubation

Incubation period of Actinomycosis varies from one to four weeks. But occasionally, it may be as long as several months.

Dissemination

Following transmission, lesions spread by direct extension.

Seeding

Once the endogenous bacteria are introduced into the tissues, they multiply due to low oxygen tension.
It triggers an inflammatory reaction which results in formation of hard yellow hard granules(sulfur granules).
These are solidified bacterial filaments with surrounding tissue exudates.
Abscesses with fibrous walls and pus along with sulfur granules develop.
It finally drain out through sinuses.

Immune response

Actinomycosis elicits both humoral and cell-mediated immune responses

Microscopic pathology

Positive for sulphur granules in pus
Gram positive organism with branching filaments forming segment-like structures
Surrounded by neutrophils

References

Template:Bacterial diseases

@@ Line 25: / Line 25: @@
 *Gram positive organism with branching filaments forming segment-like structures
 *Surrounded by neutrophils
 [[Image: Actinomyces.high magnification.jpg|center|500px]]
-{| class="wikitable"
-!Types
-!Site of Infection
-!Source of infection
-|-
-!Cervicofacial actinomycosis
-|
-* Neck
-* Jaw
-* Mouth
-|
-* Dental problems like tooth decay
-|-
-!Thoracic
-actinomycosis
-|
-* Lungs
-* Pleura
-* Chest wall
-* Mediastinum
-|
-* Inhalation of droplets of contaminated fluid
-* Aspiration of oropharyngeal secretions or gastric contents
-* Direct extension of cervicofacial infection into the mediastinum
-* Transdiaphragmatic or retroperitoneal spread from the abdomen
-* Hematogenous spread
-|-
-!Abdominal actinomycosis
-|Abdomen
-|
-* Secondary to abdominal infections like appendicitis
-* Accidental swallowing of a foreign body such as chicken bone containing the actinomycetes bacteria
-* Penetrating trauma
-* Perforation of the gut (e.g., the colon or appendix)
-* Surgical manipulation of GI tract
-|-
-!Pelvic
-actinomycosis
-|Pelvis
-|
-* Occurs most commonly in woman as the bacteria passes from the female genitals into the pelvis
-* Long-term use of IUD type of contraceptive
-|-
-!Central nervous system
-actinomycosis
-|CNS
-|
-* Secondary to hematogenous spread from primary infection in the lung, abdomen, or pelvis
-* Direct extension from paranasal sinuses, ears, and cervicofacial regions<ref name="pmid3317731">{{cite journal| author=Smego RA| title=Actinomycosis of the central nervous system. | journal=Rev Infect Dis | year= 1987 | volume= 9 | issue= 5 | pages= 855-65 | pmid=3317731 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3317731  }} </ref>
-|}
 ==References==