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Actinomycosis is a rare disease characterized by a hard, extensive infiltrate, usually on one side of the neck. The disease is caused by fungi (actinomycetes) or anaerobic microorganisms. Treatment takes place in a hospital setting.
What is Actinomycosis?
Actinomycosis is a rare disease caused by the bacteria A. Israelii. Due to bone fractures or traumatic wounds that also contain other bacteria, a microenvironment is created with a low oxygen concentration, which in turn causes the development of actinomycosis. In a healthy person, the bacterium A.israelii is a component of the oral mucosa and is present in the intestinal flora. Actinomycosis is characterized by hard and extensive lesions / ulcers usually located on one side of the neck. It usually affects the nose, throat, mouth, stomach, lungs and intestines. It appears relatively rarely elsewhere. Although actinomycosis is not contagious, it can spread to other parts of the body and is most common in tropical countries. It affects men three times more often.
The causes of actinomycosis
The causes of actinomycosis are naturally occurring in the body (it carries and throat) microorganisms from the group Actinomyces israelii. In order for actinomycosis to develop, the additional presence of three other bacteria is necessary, namely:
- Actinomyces naeslundii;
- Actinomyces odontolyticus;
- Actinomyces viscosus.
It should be to mention that actinomycosis is a rare disease, but this does not mean that you cannot catch it. Among the factors increasing the risk of this ailment, we can distinguish:
- malnutrition,
- lack of basic oral hygiene after dental procedures,
- lack of oral care after mouth or jaw injuries (e.g. a cut),
- significantly lowered immunity (e.g. due to another ailment or taking medications),
- ulcer located in the mouth (a very common cause of actinomycosis) – if you have an ulcer in the mouth, do not hesitate and consult a doctor,
- women using contraception in the form of an intrauterine device.
Types of actinomycetes
Several varieties of actinomycosis are presented below.
1. Cervico-facial actinomycetes. It is the most common type of actinomycosis, accounting for over 90% of infections. It develops as a result of tooth decay or damage, which in turn promotes infection involving the soft tissues of the mouth. In addition, the cause of this ailment is dental / dental procedures, during which harmless surface bacteria can be introduced into the tissues. Then, swelling of the subcutaneous tissue appears, which successively pierces the surface of the skin and purulent discharge begins to form. In addition, radiant drums (grains) are formed, which are masses of bacteria. As the name suggests, radiant lesions are most often located in the neck area, and the affected skin becomes red and warms (the lymph nodes are not enlarged).
2. Actinomycosis of the thorax. It appears due to the entry of A. Israelii into the lungs, where it sometimes has ideal conditions to thrive, eventually leading to pulmonary infection. Symptoms of this type of actinomycosis are thoracic fistulas, rib destruction and drainage.
3. Actinomycetes of the digestive tract. It usually occurs after inflammation and removal of the appendix, or even after a rupture of the intestine. The clinical picture shows fever, abdominal pain, abdominal weight and significant weight loss. Patients may develop an abscess in the lumbo-femoral muscle, and sometimes also an anal and rectal abscess.
4. Actinomycosis disseminated – a rare form of the disease with the presence of multiple abscesses.
5. Actinomycosis of the lesser pelvis – is a complication in women using IUDs.
What are the complications of actinomycosis?
If left untreated, actinomycosis can spread to adjacent bones and this, in turn, may necessitate surgical removal of infected parts of the bone. The situation is similar when the infection affects the nasal sinuses – damage to bones and other tissues may also be necessary.
In some (rare) cases, actinomycosis can travel to the brain and thus cause meningitis.
Actinomycosis – diagnosis and treatment
Diagnosis of actinomycosis is based primarily on collecting fluid samples from pathologically changed areas. Then the collected material is examined under a microscope in order to find actinomyces bacteria (they look like yellow granules).
Treatment of this ailment consists in taking antibiotics in the form of high doses of penicillin. If the patient is allergic to penicillin, other types of preparations can be used, e.g. erythromycin or tetracyclines and clindamycin. It happens that one year of antibiotic therapy is required for complete healing of actinomycosis.
Coexisting ulcers and skin eruptions should either be dried or removed.
Important! In women with actinomycosis caused by an intrauterine device, it must be removed!
Can actinomycosis be prevented?
In prophylaxis, the basic principle is to take care of oral hygiene. You should visit your dentist regularly, who will detect irregularities in time before they become a serious problem. Appropriate diagnosis and treatment implementation allow for complete healing of actinomycosis.