TITLE OF THE CLASS

Title

Name
Faculty of Physiotherapy
 Actinomycosis

Chronic granulomatous suppurative

fibrosing disease commonly occurring in
males(trauma & poor oral hygiene)
• Cervicofacial
• Abdominal
• Pulmonary
•Anaerobic, gram positive nonacid fast
Actinomyces israelii branched filamentous bacteria
•Normal oral flora, colon & vagina
• A. naeslundi
• A. viscosus
• A. odontolyticus
• A. propionica •Formation of abscesses that drain by
sinus tract formation
•Pus- sulfur granules, tiny yellow grains of
organisms
Actinomycosis
 Pathogenesis
It is an endogenous infection, not communicable.
It is a normal oral flora.

Port of entry- trauma, extracted socket, pdl pocket, non-

1 vital tooth or mucosal abrasion

Initial acute infection followed by chronic indolent course.

2 Lesions are single/ multiple indurations

Central fluctuance with woody, fibrous walls

3

Discharge of sulfur granules

4
 Clinical features

1.Most common 1.Extremely 1.Description of the 1.Description of the

form dangerous form company’s company’s
2.Enter thro mucosa 2.Fever, chills, products products
& spread to nausea, vomiting,
adjacent tissues intestinal 2.Description of the 2.Description of the
3.Swelling & manifestations, company’s company’s
induration of liver & spleen business business
tissues involvement
4.Woody abscess 3.Description of the 3.Description of the
with discharge of company’s company’s
sulfur granules technology technology

➢Cervicofacial ➢Abdominal ➢Description of the ➢Description of the

actinomycosis actinomycosis contents contents

Description of the contents

Histopathology

Peripheral band of fibrosis

Chronic granulation tissue

Surrounded by large collections of

PMNs (rim of neutrophils)

Colonies – club shaped filaments

Central core basophilic & peripheral
eosinophilic
 Actinomycosis
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• high doses of antibiotics (penicillin)

Treatment •Drainage of abscess
•Removal of infected tissue

• responds well to proper antibiotic therapy

Prognosis •Needs drugs for up to 12 weeks
 Noma
❖Also called as cancrum oris, gangrenous stomatitis and
necrotizing stomatitis
Derived from the Greek word “Nomein” meaning “to devour”

Borrelia vincentii and fusobacterium are thought to be key

players

Poverty, malnutrition, poor oral hygiene, immunodeficiency

Begins as necrotizing ulcerative gingivitis

Related to HIV infection/ severe immunodeficiency

 Clinical features

Typically arises in children

aged 1 to 10 yrs

• begins as NUG • Extends to • fetid odor, Noma

form necrotizing pain, fever, neonatorum
ulcerative malaise
• 1st month of low
mucositis
•Additional birth weight babies,
•Blackish lesions devastating
discoloration septicemia
 Noma
Treatment

Antibiotics, adequate nutrition, hydration and electrolyte balance

Penicillin and metronidazole – drug of choice

Treatment

Debridement of gross necrotic area

Prognosis

Significant morbidity- surgical reconstruction of face should be delayed till

infection subsides
If coupled with septicemia- can be fatal