Sandbox:Aditya
Actinomycosis
Classification
Actinomycosis can be classified based on the anatomical site involved into
Orocervicofacial actinomycosis
Thoracic actinomycosis
Abdominopelvic actinomycosis
central nervous system actinomycosis
Musculoskeletal actinomycosis
Disseminated actinomycosis
Epidemiology and Demographics
Incidence
- Actinomycosis is a rare disease.
- Maintaining proper oral hygiene and with widespread use of antibiotics its incidence had been declined
- In 1970, its annual incidence was 1 per 300,000.
Age
Actinomycosis commonly found between 4th to 6th decade of life and very rare in infants and children
Gender
Males are more commonly affected by actinomycosis than females.
Pathophysiology
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.
|
Route of transmission | |
|
Cervicofacial |
Rupture of mucosa during dental surgeries and poor oral hygiene |
|
Thoracic |
Aspiration of inoculum |
|
Abdominal |
Disrupture during abdominal surgery or perforated viscus |
|
Pelvic |
Placement of IUD |
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
There is a greater disease incidence in males between the ages of 20 and 60 years than in females.[1] Before antibiotic treatments became available, the incidence in the Netherlands and Germany was 1 per 100,000 people/year. Incidence in the U.S. in the 1970s was 1 per 300,000 people/year, while in Germany in 1984, it was estimated to be 1 per 40,000 people/year.[1] The use of intrauterine devices (IUDs) has increased incidence of genitourinary actinomycosis in females. Incidence of oral actinomycosis, which is harder to diagnose, has increased.[1]