Actinomycosis pathophysiology

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Differentiating Actinomycosis from other Diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Actinomycosis is a chronic pyogenic bacterial infection caused by actinomyces species. Infection most frequently follows dental work, trauma, surgery, or other medical conditions. When there is break in the mucosa, anywhere from the mouth to the rectum they reach tissues and cause damage. Incubation period of actinomycosis varies from one to four weeks. But occasionally, it may be as long as several months. Actinomycosis elicits both humoral and cell-mediated immune responses

Pathophysiology

Transmission

Types Site of Infection Source of infection
Cervicofacial actinomycosis
Thoracic

actinomycosis

Abdominal actinomycosis Abdomen
Pelvic

actinomycosis

Pelvis
  • Occurs most commonly in woman as the bacteria enters into the pelvis
  • Long-term use of IUD type of contraceptive
Central nervous system

actinomycosis

CNS

Incubation

Incubation period of actinomycosis varies from one to four weeks.

Dissemination

Following transmission, lesions spread by direct extension.

Seeding

Immune response

Actinomycosis elicits both humoral and cell-mediated immune responses

Genetics

There is no known genetic association to actinomycosis

Gross Pathology

On gross pathology, the following features can be noticed:

Microscopic pathology

Microscopic findings include

This is a low-power photomicrograph of the retroperitoneal abscess. At this magnification, multiple dark-staining foci can be appreciated. These foci are Actinomyces colonies (arrows). These colonies are known as "sulfur granules" because in gross specimens they are visible to the naked eye as yellow grains, thus resembling grains of sulfur.

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References

  1. Volante M, Contucci AM, Fantoni M, Ricci R, Galli J (2005). "Cervicofacial actinomycosis: still a difficult differential diagnosis". Acta Otorhinolaryngol Ital. 25 (2): 116–9. PMC 2639881. PMID 16116835.
  2. Sharkawy AA (2007). "Cervicofacial actinomycosis and mandibular osteomyelitis". Infect. Dis. Clin. North Am. 21 (2): 543–56, viii. doi:10.1016/j.idc.2007.03.007. PMID 17561082.
  3. Peipert, Jeffrey F. (2004). "Actinomyces: Normal Flora or Pathogen?". Obstetrics & Gynecology. 104 (Supplement): 1132–1133. doi:10.1097/01.AOG.0000145267.59208.e7. ISSN 0029-7844.
  4. Higashi Y, Nakamura S, Ashizawa N, Oshima K, Tanaka A, Miyazaki T, Izumikawa K, Yanagihara K, Yamamoto Y, Miyazaki Y, Mukae H, Kohno S (2017). "Pulmonary Actinomycosis Mimicking Pulmonary Aspergilloma and a Brief Review of the Literature". Intern. Med. 56 (4): 449–453. doi:10.2169/internalmedicine.56.7620. PMID 28202870.
  5. Schaal KP, Lee HJ (1992). "Actinomycete infections in humans--a review". Gene. 115 (1–2): 201–11. PMID 1612438.
  6. Brown, James R. (1973). "Human actinomycosisA study of 181 subjects". Human Pathology. 4 (3): 319–330. doi:10.1016/S0046-8177(73)80097-8. ISSN 0046-8177.
  7. Smego RA (1987). "Actinomycosis of the central nervous system". Rev Infect Dis. 9 (5): 855–65. PMID 3317731.

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