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Actinomycosis - Causes and Symptoms

Definition:

Actinomycosis is a chronic inflammatory disease of cattle, hogs, and sometimes humans, caused by microorganisms of the genus Actinomyces and characterized by lumpy tumors commonly of the face, head, thorax, abdomen and neck, that produces abscesses and open draining sinuses.

It is generally a rare disease, slowly progressive bacterial infection primarily caused by the gram-positive anaerobic bacillus Actinomyces israelii, which produces granulomatous, suppurative lesions with abscesses.

Causes

The bacteria that cause actinomycosis are present in most of the people - in the mouth and gastrointestinal tract. They cause no trouble unless they get through the skin or some other body membrane, as a result of trauma, oral or facial surgery, infection, or a dental abscess. Poor dental hygiene and dental abscess can predispose people to facial lesions and lung infections caused by these bacteria.

Actinomycosis is mainly caused by a gram-positive filamentous bacteria that do not form spores and are not acid-fast. The most common isolated species causing actinomycosis are - Actinomyces israeli and Actinomyces gerencseriae, Actinomyces turicensis, Actinomyces radingae, Actinomyces europaeus, followed by Actinomyces naeslundii.

Symptoms of Actinomycosis

Some of the Common Signs and Symptoms of Actinomycosis are:

  • Fever.
  • Abdominal Pain.
  • Abscess formation.
  • Weight Loss.
  • Draining Sinuses.
  • Abnormal vaginal bleeding and vaginal discharge.
  • Lethargy
  • Cough which may also be accompanied with sputum.
  • A swelling or hard, red-to-reddish-purple lump on the face or upper neck (see neck lumps).
  • Night Sweats.
  • Shortness of breath

Treatment of Actinomycosis

Actinomycosis is difficult to treat because of its dense tissue location. Because the diagnosis is difficult to make, surgery becomes important as both diagnosis and treatment of actinomycosis.

Some of the other Treatment options for curing actinomycosis are:

  • To kill the bacteria, large doses of penicillin are given through a vein daily for at least 4-6 weeks followed by a course of 6-12 months of penicillin taken by mouth.
  • Antibiotic Therapy:
    • Clindamycin is an effective drug, and if co-infection with other anaerobic bacteria or Staphylococcus is suspected, treatment with clindamycin is recommended.
    • Erythromycin is also effective, and is recommended in rare cases of penicillin and tetracycline allergy.
    The antibiotic therapy must be completed to insure that the infection does not return. Depending on the seriousness of the infection, it may be necessary to continue antibiotics for 6 - 12 months, to prevent relapse.
  • Hyperbaric oxygen (oxygen under high pressure) therapy in combination with the above antibiotic therapy has also shown very good results.
  • Surgical drainage of the lesion may be required.
  • The mainstay of therapy for years has been penicillin. The semi-synthetic penicillin's such as Nafcillin and Dicloxacillin are less effective.

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