Actinomycosis & Norcardiosis
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Transcript of Actinomycosis & Norcardiosis
05/03/23 1JAAS
Anaerobic, filamentous, gram positive bacillus ◦ Exhibit true branching
“Mykes” – Greek for “fungus” Thought by early microbiologist to be
fungi because of:◦ Morphology◦ Disease they cause
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Not highly virulent (Opportunist)
◦ Component of Oral Flora Periodontal pockets Dental plaque Tonsilar crypts
◦ Take advantage of injury to penetrate mucosal barriers Coincident infection Trauma Surgery
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A.israelii, A.naeslundii;
Gram positive; sulfur granule;
Related to decay tooth and peridentitis
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A chronic suppurative and granulomatous disease of the cervico-facial, thoracic or abdominal areas
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Cervicofacial Actinomycosis
NOTE: Sinus tract originating in oral cavity has made it’s way to the surface at
the jawline. 05/03/23 7JAAS
15% of cases Aspiration of
organism from the oropaharynx
Slowly progressive process involving lung and pleura◦ May be mistaken for
malignancy Chest pain, fever, wgt
loss and hemoptysis05/03/23 8JAAS
Colonized IUD Resulting in Pelvic Actinomycosis
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Form indurated masses with fibrous walls and central loculations with pus◦ Pus contains "Sulfur Granules"
Gritty, yellow white Average diameter - 2mm Composed of mineralized “mycelial” mass
Chronic infection
◦ Form burrowing sinus tracts to skin or mucus membranes Discharge purulent material
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Sputum Pus Biopsy tissue
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Gram Stain and Macroscopic Colonies of Actinomyces
NOTE: Molar tooth appearance of colonies on agar can help remind us that the oral cavity is a common niche for Actinomyces.
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Streptomyces species?
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Specimen-pus Drug of choice-penicilline
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Subcutaneous infections, pulmonary infections, and brain abscesses
N. asteroides; N. brasiliensis
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Clinical Specimens:Sputum,Pus,Biopsy tissue
Sulfamethoxazole-TrimethoprimSulfamethoxazole-Trimethoprim05/03/23 20JAAS
Endemic in the tropics and subtropicsCaused by,true fungi (eumycetoma) or by filamentous bacteria (actinomycetoma)
Male to female ratio of 2.2:1Actinomycetoma is caused by a group of filamentous bacteria, among which N. brasiliensis and
Streptomycesmadurae are the most common
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Eumycetoma is caused by a group of fungi with
thick, septate hyphae, including Allescheria boydii, Madurella griesia and Madurella Mycetomi
Surgical debridement, followed by prolongedappropriate antibiotic therapy for severalmonths is required for actinomycetoma
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Eumycetoma-thick club shaped structures (<) (H and E, ×1250)
Actinomycetoma-thin filamentous bacteria seen (H and E, ×500)Madura foot-
partially healed ulcer
THANK YOU
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