Actinomyces &
Actinomyces &
Actinomyces
Actinomyces
A.israelii,
A.israelii,
A.naeslundii;
A.naeslundii;
Gram positive;
Gram positive;
sulfur granule;
sulfur granule;
Related to
Related to
decay tooth
decay tooth
and
and
ACTINOMYCES
ACTINOMYCES
Anaerobic, filamentous, gramAnaerobic, filamentous, gram
positive bacillus
positive bacillus
• Exhibit true branchingExhibit true branching
““Mykes” – Greek for “fungus”Mykes” – Greek for “fungus”
Thought by early microbiologist to Thought by early microbiologist to
be fungi because of:
be fungi because of:
• MorphologyMorphology
Clinical specimens:Actinomycosis-pus
ACTINOMYCOSIS
ACTINOMYCOSIS
Not highly virulent
Not highly virulent
(Opportunist)
(Opportunist)
• Component of Oral FloraComponent of Oral Flora
Periodontal pocketsPeriodontal pockets Dental plaqueDental plaque
Tonsilar cryptsTonsilar crypts
• Take advantage of injury Take advantage of injury
to penetrate mucosal
to penetrate mucosal
barriers
barriers
Coincident infectionCoincident infection TraumaTrauma
Actinomycosis
Actinomycosis
A chronic suppurative and granulomatous 肉肉A chronic suppurative and granulomatous
肉 disease of the cervico-facial, thoracic or disease of the cervico-facial, thoracic or abdominal areas
ACTINOMYCOSIS
ACTINOMYCOSIS
Form indurated masses with fibrous
Form indurated masses with fibrous
walls and central loculations with
walls and central loculations with
pus
pus
• Pus contains "Sulfur Granules"Pus contains "Sulfur Granules"
Gritty, yellow whiteGritty, yellow white
Average diameter - 2mmAverage diameter - 2mm
Composed of mineralized “mycelial” massComposed of mineralized “mycelial” mass
Chronic infection
Chronic infection
• Form burrowing sinus tracts to skin or Form burrowing sinus tracts to skin or
mucus membranes
mucus membranes
Actinomycosis - sulfur granule
Pulmonary Actinomycosis
Pulmonary Actinomycosis
15% of cases15% of cases
Aspiration of organism Aspiration of organism
from the oropaharynx
from the oropaharynx
Slowly progressive Slowly progressive
process involving lung
process involving lung
and pleura
and pleura
• May be mistaken for May be mistaken for malignancy
malignancy
Chest pain, fever, wgt Chest pain, fever, wgt
loss and hemoptysis
Mycetoma
Mycetoma
(
(
足足足足
足足足足
Streptomyces Streptomyces
Nocardiosis
Nocardiosis
Subcutaneous Subcutaneous
infections, pulmonary
infections, pulmonary
infections, and brain
infections, and brain
abscesses
abscesses
N. asteroides; N. N. asteroides; N.
brasiliensis
Lab. Diagnosis
Lab. Diagnosis
Clinical Clinical
Specimens:Sputum,Pus,Biopsy tissue
Specimens:Sputum,Pus,Biopsy tissue
Sulfamethoxazole-Trimethoprim
