Actinomycosis is a rare bacterium caused infectious disease which spreads from one body organ to the other through body tissues and blood. Actinomycosis leads to pus- filled inflammation of the tissues and formation of massy knots. It affects animals more than humans. And also in humans it is more prevalent in males than in females.
What are the causes for Actinomycosis?
The Actinomyces bacteria which cause the infection live harmlessly in the body, but when the tissues undergo trauma like injury or surgery then these bacteria spread out of its safe habitat and starts multiplying rapidly causing the infection to spread. These bacteria thrive deep inside in the body tissues where the oxygen levels are low and hence when diagnosed this disease requires prolonged treatment.
What are the places where Actinomycosis can occur?
- Bone and joint
- Respiratory tract
- Digestive tract
- Urogenital tract
- Central nervous system
What are the different species of Actinomyces bacteria responsible for Actinomycosis?
- Actinomyces israelii – the most common bacteria and responsible for oral infections.
- Actinomyces gerencseriae – responsible for orocervicofacial infections.
- Actinomyces viscosus – rare bacteria
- Actinomyces meyeri – rare bacteria
- The best mode of diagnosis would be the bacteria culture of an abscess or of a suspected tissue. Prolonged bacteria culture in anaerobic conditions is required to identify the bacteria.
- Microscopic findings of the drained fluid help to know about the Gram-positive pathogens.
- CT scan or MRI scan in case a bone is involved.
What are the different types of Actinomycosis?
Actinomycosis affects the face, throat, lungs, digestive tract and genital area in common.
Most commonly called the locked jaw or the lumpy jaw syndrome, cervicofacial actinomycosis is the most common and found in 60% of the reported actinomycosis cases. Actinomyces israelii and Actinomyces gerencseriae are the bacteria responsible for this condition though other types of Actinomyces bacteria have also been reported to cause such actinomycosis.
Places of occurrence– These bacteria are present in periodontal pockets, dental plaques, tonsillar crypts, gingival crevices or on carious teeth and cause infections which may lead to brain, lung or the digestive tract organ dissemination.
Causes– Dental caries, Gingivitis, infection in the erupting teeth, poor oral hygiene, local tissue damage caused due to radiation, facial surgery or dental extraction may lead to cervicofacial actinomycosis.
Symptoms– This infection involves tissues of the upper and lower jaw, cheek, chin or the jaw joint. A painless mass is observed and pus is formed in abscesses which drain out through the sinus tracts, skin surface or oral mucus membrane.
Treatment– A prolonged course of oral medications is involved and usually high doses of amoxicillin or penicillin G is injected during the initial stages of treatment. Surgical intervention is required to remove the infected tissues and for draining out of the excessive abscesses. Dental treatment is necessary for dental caries.
Genitourinary tract Actinomycosis
This is the second most commonly occurring form of actinomycosis. This is mainly caused by Actinomyces israelii bacteria. This typically occurs in females using Intra Uterine Device (IUD). In also occurs in the primary bladder and testicles in males.
Places of occurrence– In the female genital tract and in the primary bladder. These bacteria may invade into other neighboring organs like uterus and the colon.
Causes– Bacteria build colonies in the genital tract and this is facilitated by the IUD. IUD also causes cervix erosion which aids in the invasion of bacteria in the eroded crevices.
Symptoms– Abscess formation in the genital tract, extensive fibrosis, lower abdominal pain, vaginal discharge and constipation are common symptoms for infection in the genital tract. Thickening of the bladder walls is the common symptom for primary bladder actinomycosis.
Treatment– The IUD is to be removed first. High doses of intravenous beta-lactam are given including oral medicines. Surgical intervention if necessary is performed to drain out the abscesses.
Respiratory tract actinomycosis
This includes infections in the pulmonary, bronchial and laryngeal areas. This is the third most common type of actinomycosis. Males are most affected by this respiratory tract actinomycosis.
Places of occurrence -The bacteria invade the pulmonary location including the chest wall, lungs, bronchi and the larynx.
Causes– Poor oral hygiene, existing dental disease, alcoholism, chronic lung disease, tuberculosis, renal transplants, use of steroids, or previous radiotherapy sessions are the causes for respiratory tract actinomycosis. Excessive smoking and alcohol abuse are the primary factors which lead to the bacteria infection of the lungs.
Symptoms – General symptoms include weight loss, fever and night sweats in the pulmonary location. Specific symptoms are productive cough, spitting of blood during cough, labored and difficult breathing, pulmonary cavitation and chest pain.
Treatment– Patients with respiratory tract actinomycosis require prolonged treatment with high doses of beta-lactum antibiotics and penicillin G. Surgical intervention may be required for patients with pulmonary actinomycosis especially if they have experienced spitting out blood when coughing.
Digestive tract Actinomycosis
Actinomyces israelii is the most common bacteria invading the abdominal region.
Places of occurrence– Appendix, cecum and colon are the most common places of bacteria invasion in the abdomen. Some rare cases have been reported in the liver and the pancreas too.
Causes– Previous mucosal trauma like deep gastric ulcer may cause erosion which aids rapid multiplication of bacteria in the ulcer infected area. Surgeries like appendicitis or colonic diverticulitis are factors for bacteria growth in these places.
Symptoms– The symptoms depend on the location of digestive tract actinomycosis. Patients may have difficulty in swallowing food if it involves the esophagus. Patients with actinomycosis in the colon, appendix or the cecum may have frequent abdominal pain and discomfort in the affected area.
Treatment– As with other cases of actinomycosis, prolonged antimicrobial therapy treatment is necessary for digestive tract actinomycosis. Surgery is needed only in complicated cases.
Central nervous system Actinomycosis
Central nervous system actinomycosis results in brain abscess and is usually caused by the infection in the lungs wherein the bacteria get transmitted to the brain or after a penetrating head injury. The symptoms include sensory loss and seizures and treatment involves administering penicillin G medications after the removal of pus.
Cutaneous (Skin) Actinomycosis
Cutaneous actinomycosis occurs rarely and is caused by skin disruptions. Symptoms include skin inflammation and nodular wounds. The mode of treatment is same as for other actinomycosis cases.
So if someone has oral abscess it is better to consult your dental doctor. Also women with IUD need to consult the gynecologist if there is abdominal pain or yellow discharge from the vagina. Though the disease affects people of the tropical region more, yet it is better to go to the doctor if any prevailing symptom doesn’t go off for a long time duration.
Q1. What are the general symptoms of Actinomycosis?
Answer: The general symptoms are swelling due to massy knots and inflammation of the infected area. There is tissue damage as well as abscesses (pus filled lumps). There may be body pain and fatigue accompanying fever.
Q2. Is Actinomyces bacteria solely responsible for this disease?
Answer: It is found that in more of 75% of the cases, Actinomyces bacteria do not act alone. The infections show the presence of other bacteria which together cause Actinomycosis.
Q3. What are the precautions to be taken after being diagnosed with Actinomycosis?
Answer: When the disease is diagnosed, the doctors start with medications and surgery if required is performed. Patients thereby should maintain proper oral hygiene and general health. Alcohol abuse should be stopped and chronic medical conditions should be constantly monitored and kept under control.
Q4. What are the characteristics of Actinomycosis?
Answer: Abscesses are formed and the pus is drained through the sinus tracts or mucous membranes. The pus has yellow colored granules called the sulphur granules. The pus doesn’t contain sulphur but is named so after the yellow color in it.