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Actinomycetes for health and medical microbiology
ACTINOMYCETES:
Actinomycetes are a large, diverse
group of gram-positive bacilli
with a tendency to form chains or
filaments….filamentous bacteria.
Morphology resembles the filamentous
fungi
ACTINOMYCES
Background
? Mouth commensals
? Medical importance: cause a chronic granulomatous
infection (actinomycosis)
? Important species
A. israelii
A. odontolyticus
A. gerencseriae
A. meyeri
A. viscosus
Pathogenesis
? Actinomycosis is acquired endogeneously
? Dental caries, Trauma, Dental Surgery increases the
risk of infection,
? Abscesses, tissue destruction, fibrosis and sinus
formation are typical findings
? In young lesions, masses of mycelia are visible in
yellow sulphur granules
Clinical features
1. Cervico-facial actinomycosis
- mainly around the jaw
- hematogeneous spread to liver, brain is common
2. Thoracic actinomycosis
- due to aspiration of oral actinomycetes
- Presents with chest wall sinuses and bony erosions of
ribs
Actinomycetes for health and medical microbiology
…clinical features
3. Pelvic actinomycosis
- associated with intrauterine contraceptive devices
4. Cerebral actinomycosis
5. Appendix/Colonic diverticula actinomycosis
Actinomycetes for health and medical microbiology
Diagnosis
? Specimen: Tissue biopsies
? Stain: fluorescein conjugated specific anti-sera
- characteristic granules and mycelia
- are also acid fast due to high mycolic acid content
? Culture: Incubate in microaerophillic conditions, growth in 2-10 days
Treatment
? Surgical involvement
-reduces scarring, deformity and recurrence
? Removal of IUCD if implicated
? Antimicrobial agents
- penicillin; long course therapy
- Broad spectrum eg ceftriaxone, metronidazole in
secondary infection with other pathogens
? Recurrence due to tissue penetration rather than
drug resistance
Actinomycetes for health and medical microbiology

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Actinomycetes for health and medical microbiology

  • 3. Actinomycetes are a large, diverse group of gram-positive bacilli with a tendency to form chains or filaments….filamentous bacteria. Morphology resembles the filamentous fungi
  • 5. Background ? Mouth commensals ? Medical importance: cause a chronic granulomatous infection (actinomycosis) ? Important species A. israelii A. odontolyticus A. gerencseriae A. meyeri A. viscosus
  • 6. Pathogenesis ? Actinomycosis is acquired endogeneously ? Dental caries, Trauma, Dental Surgery increases the risk of infection, ? Abscesses, tissue destruction, fibrosis and sinus formation are typical findings ? In young lesions, masses of mycelia are visible in yellow sulphur granules
  • 7. Clinical features 1. Cervico-facial actinomycosis - mainly around the jaw - hematogeneous spread to liver, brain is common 2. Thoracic actinomycosis - due to aspiration of oral actinomycetes - Presents with chest wall sinuses and bony erosions of ribs
  • 9. …clinical features 3. Pelvic actinomycosis - associated with intrauterine contraceptive devices 4. Cerebral actinomycosis 5. Appendix/Colonic diverticula actinomycosis
  • 11. Diagnosis ? Specimen: Tissue biopsies ? Stain: fluorescein conjugated specific anti-sera - characteristic granules and mycelia - are also acid fast due to high mycolic acid content ? Culture: Incubate in microaerophillic conditions, growth in 2-10 days
  • 12. Treatment ? Surgical involvement -reduces scarring, deformity and recurrence ? Removal of IUCD if implicated ? Antimicrobial agents - penicillin; long course therapy - Broad spectrum eg ceftriaxone, metronidazole in secondary infection with other pathogens ? Recurrence due to tissue penetration rather than drug resistance