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==Natural History==
==Natural History==
Once in the tissue, Actinomyces multiply and forms an [[abscess]], producing a hard, red to reddish-purple lump, often on the jaw, from which comes the condition's common name, "lumpy jaw." Eventually, the abscess breaks through the skin surface to produce a draining sinus tract. With treatment, it is completely treatable. If left untreated, patients with Actinomycosis may progress to develop focal organ involvement with mass-like features and dvelopment of sinus tracts (which can heal and re-form) leading to multiple abscess.<ref name="pmid16116835">{{cite journal |vauthors=Volante M, Contucci AM, Fantoni M, Ricci R, Galli J |title=Cervicofacial actinomycosis: still a difficult differential diagnosis |journal=Acta Otorhinolaryngol Ital |volume=25 |issue=2 |pages=116–9 |year=2005 |pmid=16116835 |pmc=2639881 |doi= |url=}}</ref><ref name="pmid17561082">{{cite journal |vauthors=Sharkawy AA |title=Cervicofacial actinomycosis and mandibular osteomyelitis |journal=Infect. Dis. Clin. North Am. |volume=21 |issue=2 |pages=543–56, viii |year=2007 |pmid=17561082 |doi=10.1016/j.idc.2007.03.007 |url=}}</ref><ref name="Peipert2004">{{cite journal|last1=Peipert|first1=Jeffrey F.|title=Actinomyces: Normal Flora or Pathogen?|journal=Obstetrics & Gynecology|volume=104|issue=Supplement|year=2004|pages=1132–1133|issn=0029-7844|doi=10.1097/01.AOG.0000145267.59208.e7}}</ref><ref name="pmid28202870">{{cite journal |vauthors=Higashi Y, Nakamura S, Ashizawa N, Oshima K, Tanaka A, Miyazaki T, Izumikawa K, Yanagihara K, Yamamoto Y, Miyazaki Y, Mukae H, Kohno S |title=Pulmonary Actinomycosis Mimicking Pulmonary Aspergilloma and a Brief Review of the Literature |journal=Intern. Med. |volume=56 |issue=4 |pages=449–453 |year=2017 |pmid=28202870 |doi=10.2169/internalmedicine.56.7620 |url=}}</ref><ref name="pmid1612438">{{cite journal |vauthors=Schaal KP, Lee HJ |title=Actinomycete infections in humans--a review |journal=Gene |volume=115 |issue=1-2 |pages=201–11 |year=1992 |pmid=1612438 |doi= |url=}}</ref><ref name="Brown1973">{{cite journal|last1=Brown|first1=James R.|title=Human actinomycosisA study of 181 subjects|journal=Human Pathology|volume=4|issue=3|year=1973|pages=319–330|issn=00468177|doi=10.1016/S0046-8177(73)80097-8}}</ref>
*Once in the tissue, actinomyces multiply and forms an [[abscess]], producing a hard, red to reddish-purple lump, often on the jaw.
*Eventually, the abscess breaks through the skin surface to produce a draining sinus tract.  
*With treatment, it is completely treatable.
*If left untreated, patients with actinomycosis may progress to develop focal organ involvement with mass-like features and development of sinus tracts (which can heal and re-form) leading to multiple abscess.<ref name="pmid16116835">{{cite journal |vauthors=Volante M, Contucci AM, Fantoni M, Ricci R, Galli J |title=Cervicofacial actinomycosis: still a difficult differential diagnosis |journal=Acta Otorhinolaryngol Ital |volume=25 |issue=2 |pages=116–9 |year=2005 |pmid=16116835 |pmc=2639881 |doi= |url=}}</ref><ref name="pmid17561082">{{cite journal |vauthors=Sharkawy AA |title=Cervicofacial actinomycosis and mandibular osteomyelitis |journal=Infect. Dis. Clin. North Am. |volume=21 |issue=2 |pages=543–56, viii |year=2007 |pmid=17561082 |doi=10.1016/j.idc.2007.03.007 |url=}}</ref><ref name="Peipert2004">{{cite journal|last1=Peipert|first1=Jeffrey F.|title=Actinomyces: Normal Flora or Pathogen?|journal=Obstetrics & Gynecology|volume=104|issue=Supplement|year=2004|pages=1132–1133|issn=0029-7844|doi=10.1097/01.AOG.0000145267.59208.e7}}</ref><ref name="pmid28202870">{{cite journal |vauthors=Higashi Y, Nakamura S, Ashizawa N, Oshima K, Tanaka A, Miyazaki T, Izumikawa K, Yanagihara K, Yamamoto Y, Miyazaki Y, Mukae H, Kohno S |title=Pulmonary Actinomycosis Mimicking Pulmonary Aspergilloma and a Brief Review of the Literature |journal=Intern. Med. |volume=56 |issue=4 |pages=449–453 |year=2017 |pmid=28202870 |doi=10.2169/internalmedicine.56.7620 |url=}}</ref><ref name="pmid1612438">{{cite journal |vauthors=Schaal KP, Lee HJ |title=Actinomycete infections in humans--a review |journal=Gene |volume=115 |issue=1-2 |pages=201–11 |year=1992 |pmid=1612438 |doi= |url=}}</ref><ref name="Brown1973">{{cite journal|last1=Brown|first1=James R.|title=Human actinomycosisA study of 181 subjects|journal=Human Pathology|volume=4|issue=3|year=1973|pages=319–330|issn=00468177|doi=10.1016/S0046-8177(73)80097-8}}</ref>


==Prognosis==
==Prognosis==

Revision as of 18:05, 30 March 2017

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

Overview

Once in the tissue, Actinomyces multiply and forms an abscess, producing a hard, red to reddish-purple lump, often on the jaw, from which comes the condition's common name, "lumpy jaw." Eventually, the abscess breaks through the skin surface to produce a draining sinus tract. With treatment, it is completely treatable.

Natural History

  • Once in the tissue, actinomyces multiply and forms an abscess, producing a hard, red to reddish-purple lump, often on the jaw.
  • Eventually, the abscess breaks through the skin surface to produce a draining sinus tract.
  • With treatment, it is completely treatable.
  • If left untreated, patients with actinomycosis may progress to develop focal organ involvement with mass-like features and development of sinus tracts (which can heal and re-form) leading to multiple abscess.[1][2][3][4][5][6]

Prognosis

  • The prognosis is generally excellent with prompt and effective antimicrobial treatment in patients with uncomplicated actinomycosis that does not affect the CNS.
  • The factors that define the outcomes of the diesease include
    • Site of infection: the highest mortality is seen if the disease involves central nervous system.
    • The time to diagnosis: delayed presentation results in poorer outcomes
    • The time to the start of appropriate treatment.
  • Mortality range from 0% to 28%.( hightest being in CNS)

Complications

Complications that can develop as a result of actinomycosis are [7]

  • Extension of disease can result in osteomyelitis of the mandible, ribs, or vertebrae.
  • Endocarditis
  • Pericarditis
  • CNS disease, including brain abscess; chronic meningitis

References

  1. Volante M, Contucci AM, Fantoni M, Ricci R, Galli J (2005). "Cervicofacial actinomycosis: still a difficult differential diagnosis". Acta Otorhinolaryngol Ital. 25 (2): 116–9. PMC 2639881. PMID 16116835.
  2. Sharkawy AA (2007). "Cervicofacial actinomycosis and mandibular osteomyelitis". Infect. Dis. Clin. North Am. 21 (2): 543–56, viii. doi:10.1016/j.idc.2007.03.007. PMID 17561082.
  3. Peipert, Jeffrey F. (2004). "Actinomyces: Normal Flora or Pathogen?". Obstetrics & Gynecology. 104 (Supplement): 1132–1133. doi:10.1097/01.AOG.0000145267.59208.e7. ISSN 0029-7844.
  4. Higashi Y, Nakamura S, Ashizawa N, Oshima K, Tanaka A, Miyazaki T, Izumikawa K, Yanagihara K, Yamamoto Y, Miyazaki Y, Mukae H, Kohno S (2017). "Pulmonary Actinomycosis Mimicking Pulmonary Aspergilloma and a Brief Review of the Literature". Intern. Med. 56 (4): 449–453. doi:10.2169/internalmedicine.56.7620. PMID 28202870.
  5. Schaal KP, Lee HJ (1992). "Actinomycete infections in humans--a review". Gene. 115 (1–2): 201–11. PMID 1612438.
  6. Brown, James R. (1973). "Human actinomycosisA study of 181 subjects". Human Pathology. 4 (3): 319–330. doi:10.1016/S0046-8177(73)80097-8. ISSN 0046-8177.
  7. Agrawal P, Vaiphei K (2014). "Renal actinomycosis". BMJ Case Rep. 2014. doi:10.1136/bcr-2014-205892. PMC 4244330. PMID 25406215.

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