Actinomycosis & Norcardiosis

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  • Anaerobic, filamentous, gram positive bacillus Exhibit true branchingMykes Greek for fungusThought by early microbiologist to be fungi because of:

    MorphologyDisease they cause

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  • Not highly virulent (Opportunist)Component of Oral FloraPeriodontal pocketsDental plaqueTonsilar cryptsTake advantage of injury to penetrate mucosal barriersCoincident infectionTraumaSurgery**JAAS

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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 ActinomycosisNOTE: Sinus tract originating in oral cavity has made its way to the surface at the jawline.**JAAS

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  • 15% of casesAspiration of organism from the oropaharynxSlowly progressive process involving lung and pleura

    May be mistaken for malignancyChest pain, fever, wgt loss and hemoptysis

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  • Colonized IUD Resulting in Pelvic Actinomycosis**JAAS

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  • Form indurated masses with fibrous walls and central loculations with pusPus contains "Sulfur Granules"Gritty, yellow whiteAverage diameter - 2mmComposed of mineralized mycelial massChronic infection Form burrowing sinus tracts to skin or mucus membranesDischarge purulent material**JAAS

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  • SputumPusBiopsy tissue

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  • Gram Stain and Macroscopic Colonies of ActinomycesNOTE: Molar tooth appearance of colonies on agar can help remind us that the oral cavity is a common niche for Actinomyces.**JAAS

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  • Streptomyces species?**JAAS

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  • Specimen-pusDrug of choice-penicilline

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  • Subcutaneous infections, pulmonary infections, and brain abscessesN. asteroides; N. brasiliensis

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  • Clinical Specimens:Sputum,Pus,Biopsy tissue

    Sulfamethoxazole-Trimethoprim**JAAS

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  • 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*JAAS*

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  • Eumycetoma is caused by a group of fungi withthick, septate hyphae, including Allescheria boydii, Madurella griesia and Madurella Mycetomi

    Surgical debridement, followed by prolongedappropriate antibiotic therapy for severalmonths is required for actinomycetoma*JAAS*

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  • *JAAS*Eumycetoma-thick club shaped structures (
  • THANK YOU

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