Actinomycosis differential diagnosis: Difference between revisions

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The following table helps in differentiating actinomycosis from nocardiosis.<ref name="pmid20463251">{{cite journal| author=Sullivan DC, Chapman SW| title=Bacteria that masquerade as fungi: actinomycosis/nocardia. | journal=Proc Am Thorac Soc | year= 2010 | volume= 7 | issue= 3 | pages= 216-21 | pmid=20463251 | doi=10.1513/pats.200907-077AL | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20463251  }} </ref>
The following table helps in differentiating actinomycosis from nocardiosis.<ref name="pmid20463251">{{cite journal| author=Sullivan DC, Chapman SW| title=Bacteria that masquerade as fungi: actinomycosis/nocardia. | journal=Proc Am Thorac Soc | year= 2010 | volume= 7 | issue= 3 | pages= 216-21 | pmid=20463251 | doi=10.1513/pats.200907-077AL | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20463251 }} </ref><ref name="pmid8821161">{{cite journal| author=Warren NG| title=Actinomycosis, nocardiosis, and actinomycetoma. | journal=Dermatol Clin | year= 1996 | volume= 14 | issue= 1 | pages= 85-95 | pmid=8821161 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8821161 }} </ref>


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Revision as of 20:28, 9 March 2017

Actinomycosis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The differential diagnosis of actinomycosis consists of blastomycosis, brain abscess, colon cancer, crohn disease, diverticulitis, liver abscess, lung abscess, lymphoma, nocardiosis, pelvic inflammatory disease, pneumonia, tuberculosis and uterine cancer.

Differential Diagnosis

Disease Differentiating signs/symptoms Differentiating tests
Abdominal Abscess
Nocardiosis
Ovarian/Oviductal tumor
Appendicitis
Blastomycosis
Brain abscess
Colon cancer
Gastric adenocarcinoma
Crohn disease
Ulcerative colitis
Diverticulitis
Liver abscess
Lung abscess
Lung cancer
Pelvic inflammatory disease
Pneumonia (fungal, bacterial, or aspiration)
Pulmonary tuberculosis
Intestinal tuberculosis
Uterine cancer
Whipple disease

The following table helps in differentiating actinomycosis from nocardiosis.[1][2]

Actinomycosis Nocardiosis
Gram positive anaerobic species Gram positive aerobe
Decreasing incidence Increasing incidence
Occurs primarily in immunocompetent host Occurs primarily in immunocompromised host
Predominant cervicofacial Predominant pulmonary
Chest wall involvement and bony erosions are common Chest wall involvement is uncommon
Granuloma formation and intense fibrosis are common. Form characteristic sulphur granules Granuloma formation and fibrosis are uncommon
Spread by direct invasion Metastatic spread is common (especially to brain)
Diagnosis is made through cytologic or histologic examination Diagnosis is made through BAL (bronchoalveolar lavage),

sputum, or pleural fluid culture

Treatment: Penicillin

Treatment with antibiotics alone

Treatment: Sulfonamides

Often need surgical drainage

References

  1. Sullivan DC, Chapman SW (2010). "Bacteria that masquerade as fungi: actinomycosis/nocardia". Proc Am Thorac Soc. 7 (3): 216–21. doi:10.1513/pats.200907-077AL. PMID 20463251.
  2. Warren NG (1996). "Actinomycosis, nocardiosis, and actinomycetoma". Dermatol Clin. 14 (1): 85–95. PMID 8821161.

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