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*Once in the tissue[[Actinomyces|, actinomyces]] multiply and forms an [[abscess]], producing a hard, red to reddish-purple lump, often on the jaw.
*Once in the tissue[[Actinomyces|, actinomyces]] multiply and forms an [[abscess]], producing a hard, red to reddish-purple lump, often on the jaw.
*Eventually, the [[abscess]] ruptures through the skin surface to produce a draining sinus tract and are completely treatable.
*Eventually, the [[abscess]] ruptures through the skin surface to produce a draining sinus tract and are completely treatable.
*If left untreated, patients with actinomycosis may progress to develop focal organ involvement with mass-like features and multiple abscess which can heal and re-form.<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>
*If left untreated, patients with actinomycosis may progress to develop focal organ involvement with mass-like features and multiple abscesses which can heal and reform.<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==
Line 19: Line 19:


==Complications==
==Complications==
Complications that can develop as a result of actinomycosis are <ref name="pmid25406215">{{cite journal |vauthors=Agrawal P, Vaiphei K |title=Renal actinomycosis |journal=BMJ Case Rep |volume=2014 |issue= |pages= |year=2014 |pmid=25406215 |pmc=4244330 |doi=10.1136/bcr-2014-205892 |url=}}</ref>
Complications that can develop as a result of [[actinomycosis]] are <ref name="pmid25406215">{{cite journal |vauthors=Agrawal P, Vaiphei K |title=Renal actinomycosis |journal=BMJ Case Rep |volume=2014 |issue= |pages= |year=2014 |pmid=25406215 |pmc=4244330 |doi=10.1136/bcr-2014-205892 |url=}}</ref>
*Extension of disease can result in osteomyelitis of the mandible, ribs, or vertebrae.
*Extension of disease can result in osteomyelitis of the mandible, ribs, or vertebrae.
*Endocarditis  
*Endocarditis  
*Pericarditis
*Pericarditis
*Brain absces
*Brain abscess
*Meningitis
*Meningitis


Revision as of 18:33, 30 March 2017

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

Overview

Once in the tissue, actinomyces multiply and forms an abscess, producing a hard, red to reddish-purple lump, most commonly on the jaw. Eventually, the abscess ruptures through the skin surface producing a draining sinus tract. If left untreated, patients with actinomycosis may progress to develop multiple abscesses which can heal and reappear. The prognosis is excellent with prompt and effective antimicrobial treatment. Complications that can develop as a result of actinomycosis are osteomyelitis, endocarditis, pericarditis and meningitis.

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 ruptures through the skin surface to produce a draining sinus tract and are completely treatable.
  • If left untreated, patients with actinomycosis may progress to develop focal organ involvement with mass-like features and multiple abscesses which can heal and reform.[1][2][3][4][5][6]

Prognosis

  • The prognosis is 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 disease include:
    • Site of infection
    • The time to diagnose
    • The time to the start of appropriate treatment
  • Mortality range from 0% to 28% highest 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
  • Brain abscess
  • 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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