A Family Doctor’s Tale – ACTINOMYCOSIS
DOC I HAVE ACTINOMYCOSIS
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What is Actinomycosis?
Actinomycosis fever is a chronic infection caused by the Actinomycosis anaerobic gram positive bacteria (Actinomyces israeli) associated with multiple draining abscesses.
There are 4 forms of Actinomycosis:
1.General:
affects the whole body including skin, brain, bones, kidney, liver and female pelvic organs
2.Cervicofacial (neck and face) form arises in decayed teeth
3.Respiratory form is caused by aspiration of oral secretions
4.Abdominal form has transmucosal (through the mucosal lining of the intestine) spread.
Discharge from multiple communicating abscesses contain sulfur granules in the fluid.
They are yellowish granules made of clumped micro-organisms.
The most common location is in the neck and facial region.
The bacteria enters the tissues of the neck or face through injury, dental surgery and infection.
Very common cause of infection is a dental abscess or dental surgery.
Sometimes Intra uterine Device in the womb of women may also cause infection by the Actinomycosis bacteria.
Once inside the tissues of the neck or face it forms a lump (abscess) at the lower jaw. Once the abscess burst , pus pours out from a sinus tract in the skin of the jaw.
What are the symptoms of Actinomycosis?
Symptoms are:
A.Cervicofacial:
1.affects the cheeks, tongue, pharynx, salivary glands, skull bones, meninges and brain
2.small flat hard swellings which soften forming sinuses and fistula
B.Thoracic form:
same symptoms as tuberculosis
1.fever
2.pain
3.chronic cough
4.perforation of chest wall with sinuses
C.Abdominal form:
affects appendix and caecum
1.pain,
2.fever
3.constipation
4.diarrhea
5.palpable mass
6.draining sinuses and fistula
D.General:
has blood spread to the whole body including skin, brain, bones, kidney, liver and female pelvic organs
Diagnosis of Actinomycosis is by:
1.presence of Actinomyces israeli in sputum, pus or biopsy specimen
2.Examination of drained fluid under a microscope shows sulfur granules in the fluid
3.X rays of the chest and jaws
What are the complications of Actinomycosis?
The complications of Actinomycosis are:
1.pneumonia
2.neurological disturbances(seizures,cranial nerve signs and coma) may indicate bleeding in the brain
3.large abscesses which may lead to sepsis
What is the treatment of Actinomycosis?
Treatment of Actinomycosis:
1.antibiotic according to sensitivity
2.continuous antibiotic for months
3.surgical drainage of abscesses
4.laparotomy and surgical excision of abdominal forms
What is the prognosis of Actinomycosis?
Prognosis:
This depends on extent of disease
It is a slow progressive disease
The best prognosis is treatment of the cervicofacial form
The prognosis is poor in pulmonary, abdominal and generalized forms respectively.
Tagged with: Abdomen • Abscess • Actinomyces • Brain • Conditions and Diseases • Health • Surgery
Filed under: Medical case Studies
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