Actinomycosis

Actinomycosis

ActinomycosisMicrobiology

Caused by actinomyces israeli

Gram+ pleomorphic anaerobic bacterium

Related to morphology of fungus andMycobacterium

Not acid fast

Rod shaped form found “normally” indental caries, gingival margins, tonsillarcrypts and GI tract

ActinomycosisGeneral

Once, most common pulmonary fungaldisease

People with very poor dental hygiene andthose that are immunosuppressedpredisposed

White or yellow “sulfur granules” inexudate are really mycelial clumps

ActinomycosisOrgan Systems Affected

Mandibulofacial area

Intestinal tract

Lung

In That Order

ActinomycosisMandibulofacial

Osteomyelitis of the mandible

Soft tissue mass

 “Lumpy jaw”

ActinomycosisIntestinal

Resembles Crohn’s disease

May produce rupture of a hollow viscus,especially appendix

May produce fistula formation

ActinomycosisPulmonary

Consolidation which extends throughfissure

Peripheral and lower lobe

Abscess

Empyema

If chronic  severe fibrosis

ActinomycosisExtends Through Pleura

Osteomyelitis of the rib

Wavy periosteal reaction

Rarely rib destruction

Draining chest wall sinuses

Differential DiagnosisConsolidation  Chest Wall

Actinomycosis

Blastomycosis

TB

Crytococcosis