Actinomycosis natural history

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

Overview

Once in the tissue, it 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

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)

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

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

Possible Complications

Meningitis can rarely develop from this infection.

References

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