Actinomyces & Nocardia

Actinomyces A.israelii, A.naeslundii; Gram positive; sulfur granule; Related to decay tooth and peridentitis

ACTINOMYCES
Anaerobic, filamentous, gram positive bacillus
Exhibit true branching

Mykes Greek for fungus Thought by early microbiologist to be fungi because of:
Morphology Disease they cause

Clinical specimens:Actinomycosis-pus

ACTINOMYCOSIS
Not highly virulent (Opportunist)
Component Flora

of

Oral

Periodontal pockets Dental plaque Tonsilar crypts

Take advantage of injury to penetrate mucosal barriers

Coincident infection Trauma

Actinomycosis

A chronic suppurative and granulomatous disease of the cervico-facial, thoracic or abdominal areas

ACTINOMYCOSIS
Form indurated masses with fibrous walls and central loculations with pus
Pus contains "Sulfur Granules"
Gritty, yellow white Average diameter - 2mm Composed of mineralized mycelial mass

Chronic infection
Form burrowing sinus tracts to skin or mucus membranes

Discharge purulent material

Actinomycosis - sulfur granule

Pulmonary Actinomycosis

15% of cases Aspiration of organism from the oropaharynx Slowly progressive process involving lung and pleura
May be mistaken for malignancy

Chest pain, fever, wgt

Mycetoma (

Streptomyces species?

Nocardiosis

Subcutaneous infections, pulmonary infections, and brain abscesses N. asteroides; N. brasiliensis

Lab. Diagnosis

Clinical Specimens:Sputum,Pus,Biopsy tissue

Sulfamethoxazole-Trimethoprim