Professional Documents
Culture Documents
Actinomycosis
Raymond A. Smego, Jr., and Ginamarie Foglia From the Department of Infectious Diseases and Clinical Microbiology,
University of the Witwatersrand, and the South African Institute for
Medical Research, Johannesburg, Republic of South Africa; and the
Section of Infectious Diseases, Robert C. Byrd Health Sciences Center,
West Virginia University, Morgantown, West Virginia, USA
genic Actinomyces species [12, 13]. Actinomycosis in cattle, sis ranges from 11% [26] to 97% [27], with a mean frequency
horses, and other animals is caused by other species, usually of 55% [19]. Actinomyces species are normally present in high
Actinomyces bovis [14, 15]. concentrations in the tonsillar crypts and gingivodental crev-
ices, and many actinomyces infections are odontogenic in ori-
Pathogenesis and Pathology
gin. In addition to poor dentition and recent dental manipula-
Four clinical forms of actinomycosis, i.e., cervicofacial, tho- tion, chronic tonsillitis, otitis, and mastoiditis are important
racic, abdominopelvic, and cerebral, account for the majority risk factors for these infections. External trauma may result in
of infections in humans. Actinomycosis usually occurs in im- the introduction of Actinomyces species into head and neck
munocompetent persons but may occur in persons with dimin- tissues. Cervicofacial actinomycosis may take the form of
ished host defenses. In a previously cited study [3], several acute, painful pyogenic abscesses or indolent disease that re-
patients with abscesses, diabetic foot ulcers, cellulitis, and bac- sembles the lumpy jaw caused by A. bovis in cattle [14]. The
teremia due to A. neuii were immunosuppressed. Bacteria iso-
53. Wickbom GI, Davidson AJ. Angiographic findings in intracranial actino- 73. Littman ML, Phillips GE, Fusillo MH. In vitro susceptibility of human
mycosis: a case report and consideration of pathogenesis. Radiology pathogenic actinomycetes to chloramphenicol (chloromycetin). Am J
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55. Bolton CF, Ashenhurst EM. Actinomycosis of the brain: case report and 75. McLean IW Jr, Schwab JL, Hillegas AB, Schlingman AS. Susceptibility
review of the literature. Can Med Assoc J 1964; 90:922 – 8. of micro-organisms to chloramphenicol (chloromycetin). J Clin Invest
56. Smego RA Jr. Actinomycosis of the central nervous system. Rev Infect 1949; 28:953 – 63.
Dis 1987; 9:855 – 65. 76. Holmberg K, Nord CE, Dornbusch K. Antimicrobial in vitro susceptibility
57. Nonaka N, Takamoto K, Marubayaski T, Matsukado Y. Actinomycotic of Actinomyces israelii and Arachnia propionica. Scand J Infect Dis
brain abscess: case report. No Shinkei Geka 1978; 6:1219 – 23. 1977; 9:40 – 5.
58. Pantazopoulos PE. Actinomycosis of brain manifested by vestibular symp- 77. Schaal KP. Genus Actinomyces. In: Sneath PHA, Mair NS, Sharpe ME,
toms. Arch Otolaryngol 1964; 80:309 – 12. Holt JG, eds. Bergey’s manual of systematic bacteriology. Vol 2. Balti-
59. Powers JM, Dodds HM. Primary actinomycoma of the third ventricle —