Actinomycosis pathophysiology: Difference between revisions
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*Actinomyces are part of natural flora of human body,resides in the oral cavity, lower gastrointestinal tract and urogenital tract. | *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 | *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. | *When there is break in the mucosa, anywhere from the mouth to the rectum they reach tissues and cause damage. | ||
{| 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> | |||
|} | |||
===Incubation === | ===Incubation === | ||
[[Incubation period]] of Actinomycosis varies from one to four weeks. But occasionally, it may be as long as several months. | [[Incubation period]] of Actinomycosis varies from one to four weeks. But occasionally, it may be as long as several months. |
Revision as of 14:24, 20 March 2017
Actinomycosis Microchapters |
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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.
Types | Site of Infection | Source of infection |
---|---|---|
Cervicofacial actinomycosis |
|
|
Thoracic
actinomycosis |
|
|
Abdominal actinomycosis | Abdomen |
|
Pelvic
actinomycosis |
Pelvis |
|
Central nervous system
actinomycosis |
CNS |
|
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
- ↑ Smego RA (1987). "Actinomycosis of the central nervous system". Rev Infect Dis. 9 (5): 855–65. PMID 3317731.