Everything about Actinomyces totally explained
Actinomyces is a
genus of the
actinobacteria class of
bacteria. They are all
Gram-positive and can be either
anaerobic or
facultatively anaerobic .
Actinomyces species don't form
endospores, and, while individual bacteria are rod-shaped, morphologically
Actinomyces colonies form
fungus-like branched networks of
hyphae.
Actinomyces are known for causing disease in humans, and for the important role they play in
soil ecology. They produce a number of enzymes that help degrade
organic plant material,
lignin and
chitin. As such, their presence is important in the formation of
compost.
Many
Actinomyces species are opportunistic pathogens of humans and other mammals, particularly in the
oral cavity. In rare cases, these bacteria can cause
actinomycosis, a disease characterized by the formation of
abscesses in the mouth, lungs, or the
gastrointestinal tract.
Some species are responsible for the smell of topsoil, which is often particularly noticeable after rain. The main chemical responsible from this smell is
geosmin.
Disease
Actinomycosis is most frequently caused by
Actinomyces israelii and is sometimes known as the "most misdiagnosed disease," as it's frequently confused with neoplasms.
A. israelii is a normal colonizer of the vagina, colon, and mouth. Infection is established first by a breach of the mucosal barrier during various procedures (dental, GI), aspiration, or pathologies such as diverticulitis. The chronic phase of this disease is also known the "classic phase" because the acute, early phase is often missed by health care providers. This is characterized by slow contiguous growth that ignores tissue planes and forms a sinus tract that can spontaneously heal and recur, leading to a densely fibrotic lesion. This lesion is often characterized as "wooden." Sulfur granules form in a central purulence surrounded by neutrophils. This conglomeration of organisms is virtually diagnostic of
Actinomyces israelii. Oral-cervicofacial disease is the most common form of actinomycosis. It is characterized by a painless "lumpy jaw." Lymphadenopathy is uncommon in this form of the disease. Another form of actinomycosis is thoracic disease, which is often misdiagnosed as a neoplasm, as it forms a mass that extends to the chest wall. It arises from aspiration of organisms from the oropharynx. Symptoms include chest pain, fever, and weight loss. Abdominal disease is another manifestation of actinomycosis. This can lead to a sinus tract that drains to the abdominal wall or the perianal area. Pelvic actinomycosis is often caused by
intrauterine devices (
IUD). Symptoms include fever, abdominal pain, and weight loss. Actinomyces sp. have also been shown to infect the central nervous system in a dog "without history or evidence of previous trauma or other organ involvement."
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Treatment
Treatment for actinomycosis consists of antibiotics such as penicillin or amoxicillin for six to twelve months, as well as surgery if the disease is extensive.
Diagnosis
Consider actinomycosis when the patient has chronic progression of disease across tissue planes that's mass-like at times, sinus tract development that may heal and recur, and refractory infection after a typical course of antibiotics.
Further Information
Get more info on 'Actinomyces'.
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