Materiały źródłowe

• #1 Actinomycosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482151/

  Actinomyces are gram-positive filamentous non-acid fast anaerobic to microaerophilic bacteria that typically colonize the human mouth, urogenital tract, and gastrointestinal tract but can cause an infection known as actinomycosis. The infection is usually granulomatous, suppurative, and may involve multiple sulfur-containing abscesses that form sinus tracts. Actinomycosis is generally not diagnosed until the chronic phase. […] The bacteria infects by inhibiting host defenses and/or reducing partial pressures of oxygen. […] The organism is not virulent and only invades the body to cause deeper infections when there is tissue injury and a subsequent break in the normal mucosal barrier. Infection is mostly polymicrobial, with as many as 5 to 10 other bacterial species present. The infection is established with the help of a companion bacteria by inhibiting host defenses, reducing oxygen tension, or by producing a toxin that facilitates the inoculation of actinomycoses.

• #2 Actinomycosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/211587-overview

  Actinomycosis is a subacute-to-chronic bacterial infection caused by filamentous, gram-positive, nonacid-fast, anaerobic-to-microaerophilic bacteria. It is characterized by contiguous spread, suppurative and granulomatous inflammation, and formation of multiple abscesses and sinus tracts that may discharge sulfur granules. […] Because these microorganisms are not virulent, they require a break in the integrity of the mucous membranes and the presence of devitalized tissue to invade deeper body structures and to cause human illness. […] Furthermore, actinomycosis is generally a polymicrobial infection, with isolates numbering as many as 5-10 bacterial species. Establishment of human infection may require the presence of such companion bacteria, which participate in the production of infection by elaborating a toxin or enzyme or by inhibiting host defenses. These companion bacteria appear to act as copathogens that enhance the relatively low invasiveness of actinomycetes.

• #3 ACTINOMYCOSIS | Harrison’s Manual of Medicine

  https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623245/all/ACTINOMYCOSIS

  Actinomycosis is caused by anaerobic or microaerophilic bacteria, primarily of the genus Actinomyces (e.g., A. israelii, A. naeslundii, A. odontolyticus), that colonize the mouth, colon, and vagina. Most infections are polymicrobial, but the role of other species in the pathogenesis of the disease is unclear.

• #4 Actinomycosis | SpringerLink

  https://link.springer.com/10.1007%2F978-3-642-02202-9_98

  The genus Actinomyces consists of a heterogeneous group of gram-positive, non-spore forming catalase-negative pleomorphic rods that form a significant component of the commensal microflora of the oral, gastrointestinal, and female genital tracts and that are generally of low pathogenicity. Actinomyces species may invade via damaged mucosa, leading to bacteremia and systemic infections in both healthy individuals and immunocompromised patients. […] Actinomycosis is a catalase-negative infection and important to consider in chronic granulomatous disease (CGD). […] Of the 14 human actinomyces species, six may cause disease in humans, including the facultative anaerobic A. israelli, A. naeslundii, A. odontolyticus, A. visosus, A. meyeri, and A. gerencseriae. Actinomyces are fastidious bacteria that require cultures enriched with brain-heart infusion media, may be aided in growth by an atmosphere of 610% ambient CO2, and grow best at 37C.

• #5 ACTINOMYCOSIS | Harrison’s Manual of Medicine

  https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623245/all/ACTINOMYCOSIS

  Actinomycosis is caused by anaerobic or microaerophilic bacteria, primarily of the genus Actinomyces (e.g., A. israelii, A. naeslundii, A. odontolyticus), that colonize the mouth, colon, and vagina. Most infections are polymicrobial, but the role of other species in the pathogenesis of the disease is unclear.

• #6 The Korean Journal of Internal Medicine

  https://www.kjim.org/m/journal/view.php?number=8014

  Actinomycosis is an infectious disease caused by certain Actinomyces species. Actinomyces are Gram-positive, non-spore forming organisms characterized by obligate or facultative anaerobic rods that normally inhabit anaerobic niches of the human oral cavity. […] Actinomycosis is a chronic suppurative infection which infiltrates mucosa-associated tissues. […] A pivotal step in the pathogenesis of actinomycosis is disruption of the mucosal barrier. […] The hallmark of actinomycosis is the formation of the yellow sulfur granules. […] Actinomycosis has been called the most misdiagnosed disease and there is no disease which is so often missed by experienced clinicians. […] The radiographic findings are dependent on the chronicity of the disease. […] There are a few case reports of endobronchial actinomycosis. […] The treatment of choice for infection with Actinomyces is penicillin.

• #7 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic bacteria, primarily from the genus Actinomyces, that normally colonize the mouth, colon, and vagina. Disruption of mucosa may lead to infection of virtually any site. […] A pivotal step in the pathogenesis of actinomycosis is disruption of mucosal or epithelial barriers enabling entry of colonizing Actinomyces or related genera. Oral and cervicofacial disease is frequently associated with dental procedures, trauma, oral surgery, head and neck radiotherapy, or oncologic surgical procedures. Pulmonary infections often arise in the setting of aspiration, and abdominal infection is usually preceded by conditions that result in loss of mucosal integrity, such as surgery, diverticulitis, appendicitis, or foreign bodies (e.g., fish bones). Recognition of factors that enable bacterial entry into deep tissues, however, may be absent. The lack of such a history should not prevent consideration of this disease when the clinical circumstance is appropriate.

• #8 Actinomycosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482151/

  Actinomyces are gram-positive filamentous non-acid fast anaerobic to microaerophilic bacteria that typically colonize the human mouth, urogenital tract, and gastrointestinal tract but can cause an infection known as actinomycosis. The infection is usually granulomatous, suppurative, and may involve multiple sulfur-containing abscesses that form sinus tracts. Actinomycosis is generally not diagnosed until the chronic phase. […] The bacteria infects by inhibiting host defenses and/or reducing partial pressures of oxygen. […] The organism is not virulent and only invades the body to cause deeper infections when there is tissue injury and a subsequent break in the normal mucosal barrier. Infection is mostly polymicrobial, with as many as 5 to 10 other bacterial species present. The infection is established with the help of a companion bacteria by inhibiting host defenses, reducing oxygen tension, or by producing a toxin that facilitates the inoculation of actinomycoses.

• #9 Actinomycosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/211587-overview

  Actinomycosis is a subacute-to-chronic bacterial infection caused by filamentous, gram-positive, nonacid-fast, anaerobic-to-microaerophilic bacteria. It is characterized by contiguous spread, suppurative and granulomatous inflammation, and formation of multiple abscesses and sinus tracts that may discharge sulfur granules. […] Because these microorganisms are not virulent, they require a break in the integrity of the mucous membranes and the presence of devitalized tissue to invade deeper body structures and to cause human illness. […] Furthermore, actinomycosis is generally a polymicrobial infection, with isolates numbering as many as 5-10 bacterial species. Establishment of human infection may require the presence of such companion bacteria, which participate in the production of infection by elaborating a toxin or enzyme or by inhibiting host defenses. These companion bacteria appear to act as copathogens that enhance the relatively low invasiveness of actinomycetes.

• #10 Actinomycosis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000599.htm

  Actinomycosis is usually caused by the bacterium called Actinomyces israelii. This is a common organism found in the nose and throat. It normally does not cause disease. […] Symptoms occur when the bacteria enter the tissues of the face after trauma, surgery, or infection. Common triggers include dental abscess or oral surgery. […] Once in the tissue, the bacteria cause an abscess, producing a hard, red to reddish-purple lump, often on the jaw, from which comes the condition’s common name, „lumpy jaw.” […] Eventually, the abscess breaks through the skin surface to produce a draining sinus tract.

• #11 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic bacteria, primarily from the genus Actinomyces, that normally colonize the mouth, colon, and vagina. Disruption of mucosa may lead to infection of virtually any site. […] A pivotal step in the pathogenesis of actinomycosis is disruption of mucosal or epithelial barriers enabling entry of colonizing Actinomyces or related genera. Oral and cervicofacial disease is frequently associated with dental procedures, trauma, oral surgery, head and neck radiotherapy, or oncologic surgical procedures. Pulmonary infections often arise in the setting of aspiration, and abdominal infection is usually preceded by conditions that result in loss of mucosal integrity, such as surgery, diverticulitis, appendicitis, or foreign bodies (e.g., fish bones). Recognition of factors that enable bacterial entry into deep tissues, however, may be absent. The lack of such a history should not prevent consideration of this disease when the clinical circumstance is appropriate.

• #12 SciELO Brazil – Actinomycosis in the maxilla of a young asymptomatic patient: unusual case report Actinomycosis in the maxilla of a young asymptomatic patient: unusual case report

  https://www.scielo.br/j/rgo/a/LdSs66RdnQG5nzQBFxJGQVm/

  Actinomycosis is a subacute to chronic infection caused by filamentous Gram-positive bacteria, anaerobic, non-acidic and without spores. […] The pathogenesis of cervicofacial actinomycosis is not exactly known, however, dental caries and trauma seem to be favorable factors to the development of the disease. Loss of mucosal integrity caused by tooth extractions, periodontal disease, local anesthesia, bone or dental fractures, tooth eruption, pulp exposure or even endodontic treatment and non-vital teeth can function as a gateway for these bacteria, and thus, start the infection. […] Actinomyces can live in the oropharynx, gastrointestinal tract and urogenital tract as a normal microbiota, acting as commensals. […] Typically, these bacteria have low potential for pathogenicity or invasion, but they become pathological when gaining access to subcutaneous tissues.

• #13 Actinomycosis: Diagnosis, Clinical Features and Treatment | IntechOpen

  https://www.intechopen.com/chapters/82972

  The condition is usually considered as infrequent, however the epidemiologic data is very limited and probable underreported. Infection involving the cervicofacial area is the most commonly known, representing 60% of the cases. The organism can invade any abdominal tissue, most commonly the bowel, causing appendicitis in 65% of the cases, but also, gastrointestinal perforation and upper and lower bowel obstruction have been reported. The third most common presentation is thoracic actinomycosis (15-20% of the reported cases). Infection develop after aspiration of the oropharyngeal secretions or perforation of the esophagus. Some cases develop from progression from cervicofacial or abdominal actinomycosis, or after hematogenous spread in disseminated disease. […] Actinomycosis is considered an endogenous infection. This organism can affect immunocompromise and immunocompetent hosts. Risk factors associated with the acquisition of actinomycosis include: male sex between 20 and 60 years old, diabetics, poor oral hygiene, implanted foreign bodies as occurs during aspiration, or intrauterine implantable contraceptive device (IUD). Also, the use of immunosuppressive therapy, as systemic steroids or chemotherapy, has also being identified as possible risk factor for localized and disseminated infection. Other identified factors to acquire the infection include history of HIV, active hematogenous and solid malignancy, organ transplant, alcohol abuse, and accidental or intentional tissue trauma, as tissue radiation or surgery.

• #14 Thoracic actinomycosis infection | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/thoracic-actinomycosis-infection?embed_domain=hackmd.io%2525252525252F%25252525252540yipuafecsl2jsu8smr5njq%2525252525252Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.png&lang=us

  Thoracic actinomycosis refers to an uncommon indolent infection caused principally by the genus Actinomyces (higher prokaryotic bacteria belonging to the family Actinomyceataceae). […] Thoracic involvement usually results from aspiration of oropharyngeal or gastrointestinal secretions into the respiratory tract. Actinomyces israelii can be commonly found in the oral cavity (especially in those with poor oral hygiene or from extension of cervicofacial infections), and is thought to be responsible for the majority of pulmonary actinomyces infections. […] There may be a peripheral and/or lower lobe predominance which probably reflects the role of aspiration in its pathogenesis.

• #15 Actinomycosis: Diagnosis, Clinical Features and Treatment | IntechOpen

  https://www.intechopen.com/chapters/82972

  Actinomycosis is a filamentous bacterium that forms part of the normal human flora of the gastrointestinal, oropharynx and female genitalia. This indolent infection is characterized by abscess formation, widespread granulomatous disease, fibrosis, cavitary lung lesions and mass-like consolidations, simulating an active malignancy or systemic inflammatory diseases. The pathogenic characteristics of Actinomycosis, its capability to disseminate and grow in different environments and tissues, and its indolent and resistant presentation, has allowed this organism to confuse the clinician before obtaining a diagnosis and start treatment. The pathological damage cause by these organisms are secondary to direct tissue invasion and damage by the bacterial population. Also, actinomyces is often found cohabitating with other bacteria as Eikenella, Enterobacteriaceace, and species of Fusobacterium, Bacteroides, Capnocytophagia, Staphylococci, and Streptococci. It has been always a question of how those other organisms contribute to the pathogenesis of actinomycosis. It is believed that the cohabitant bacterias create an ecosystem that facilitates bacterial spread and growth of the actinomyces.

• #16 Actinomycosis of the reproductive organs – Own experience

  https://www.oatext.com/actinomycosis-of-the-reproductive-organs-own-experience.php

  Actinomycosis is a rare chronic infectious disease caused by microbes of low virulence. The infection occurs when the tissue barrier gets broken, often in cases of decreased immunity. The disease usually develops as a consequence of trauma, surgery, endoscopic procedure or the presence of a foreign body. […] For the infection to develop it is necessary to break the tissue barrier or decreased immunity. The disease usually results from trauma, surgery, endoscopic procedure or the presence of a foreign body. […] Actinomyces responsible for actinomycosis, a special type of IUD-related uterine infection, belong to the saprophytic flora, so they are causative factors of endogenous infections. They reside mainly in the mouth. Either Actinomyces israelii or Actinomyces gerencseriae is responsible for nearly 70% of the infections.

• #17 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Foreign bodies appear to facilitate infection. This association has been most commonly observed with IUCDs and pelvic actinomycosis. Associations with actinomycosis and foreign material elsewhere are less strong. Aspirated, ingested, or implanted foreign bodies may contribute to pathogenesis via facilitating the growth and survival, and biofilm formation. […] Cases of actinomycosis have been described in the settings of steroid use, antiTNF- agents, bisphosphonate treatment, radionecrosis, acute leukemia during chemotherapy, organ transplantation, common variable immunodeficiency, chronic granulomatous disease, and human immunodeficiency virus (HIV) infection. Ulcerative mucosal lesions (herpes simplex virus, cytomegalovirus, chemotherapy) and abnormalities in host defenses likely facilitated the development of actinomycosis in some HIV-associated cases; however, it remains unclear which arm(s) of the host defense are critical in preventing or controlling this infection and the degree to which the incidence of infection is increased in these settings.

• #18 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic bacteria, primarily from the genus Actinomyces, that normally colonize the mouth, colon, and vagina. Disruption of mucosa may lead to infection of virtually any site. […] A pivotal step in the pathogenesis of actinomycosis is disruption of mucosal or epithelial barriers enabling entry of colonizing Actinomyces or related genera. Oral and cervicofacial disease is frequently associated with dental procedures, trauma, oral surgery, head and neck radiotherapy, or oncologic surgical procedures. Pulmonary infections often arise in the setting of aspiration, and abdominal infection is usually preceded by conditions that result in loss of mucosal integrity, such as surgery, diverticulitis, appendicitis, or foreign bodies (e.g., fish bones). Recognition of factors that enable bacterial entry into deep tissues, however, may be absent. The lack of such a history should not prevent consideration of this disease when the clinical circumstance is appropriate.

• #19 Actinomycosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482151/

  Actinomyces are gram-positive filamentous non-acid fast anaerobic to microaerophilic bacteria that typically colonize the human mouth, urogenital tract, and gastrointestinal tract but can cause an infection known as actinomycosis. The infection is usually granulomatous, suppurative, and may involve multiple sulfur-containing abscesses that form sinus tracts. Actinomycosis is generally not diagnosed until the chronic phase. […] The bacteria infects by inhibiting host defenses and/or reducing partial pressures of oxygen. […] The organism is not virulent and only invades the body to cause deeper infections when there is tissue injury and a subsequent break in the normal mucosal barrier. Infection is mostly polymicrobial, with as many as 5 to 10 other bacterial species present. The infection is established with the help of a companion bacteria by inhibiting host defenses, reducing oxygen tension, or by producing a toxin that facilitates the inoculation of actinomycoses.

• #20 Actinomycosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/211587-overview

  Actinomycosis is a subacute-to-chronic bacterial infection caused by filamentous, gram-positive, nonacid-fast, anaerobic-to-microaerophilic bacteria. It is characterized by contiguous spread, suppurative and granulomatous inflammation, and formation of multiple abscesses and sinus tracts that may discharge sulfur granules. […] Because these microorganisms are not virulent, they require a break in the integrity of the mucous membranes and the presence of devitalized tissue to invade deeper body structures and to cause human illness. […] Furthermore, actinomycosis is generally a polymicrobial infection, with isolates numbering as many as 5-10 bacterial species. Establishment of human infection may require the presence of such companion bacteria, which participate in the production of infection by elaborating a toxin or enzyme or by inhibiting host defenses. These companion bacteria appear to act as copathogens that enhance the relatively low invasiveness of actinomycetes.

• #21 Actinomycosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482151/

  Actinomyces are gram-positive filamentous non-acid fast anaerobic to microaerophilic bacteria that typically colonize the human mouth, urogenital tract, and gastrointestinal tract but can cause an infection known as actinomycosis. The infection is usually granulomatous, suppurative, and may involve multiple sulfur-containing abscesses that form sinus tracts. Actinomycosis is generally not diagnosed until the chronic phase. […] The bacteria infects by inhibiting host defenses and/or reducing partial pressures of oxygen. […] The organism is not virulent and only invades the body to cause deeper infections when there is tissue injury and a subsequent break in the normal mucosal barrier. Infection is mostly polymicrobial, with as many as 5 to 10 other bacterial species present. The infection is established with the help of a companion bacteria by inhibiting host defenses, reducing oxygen tension, or by producing a toxin that facilitates the inoculation of actinomycoses.

• #22 Actinomycosis | PPT

  https://www.slideshare.net/RohitKumar3091/actinomycosis-238515929

  Actinomyces species are present as normal flora of the oral cavity and also in the lower gastrointestinal tract and female genital tract of human hosts. Establishment of human infection by Actinomyces always requires the presence of companion bacteria. […] These companion bacteria help in initiation of infection by producing a toxin or enzyme or by inhibiting host immunity. Infection by Actinomyces typically spreads contiguously and invades surrounding tissues and organs. Finally, the infection results in the production of draining sinus tracts, which contain lot of damaged tissue. And the Bacteria from this site may disseminate through blood circulation to distant organs. […] Actinomycosis is a subacute and chronic bacterial infection characterized by contiguous spread and suppurative and granulomatous inflammation.

• #23 Actinomycosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482151/

  Actinomyces are gram-positive filamentous non-acid fast anaerobic to microaerophilic bacteria that typically colonize the human mouth, urogenital tract, and gastrointestinal tract but can cause an infection known as actinomycosis. The infection is usually granulomatous, suppurative, and may involve multiple sulfur-containing abscesses that form sinus tracts. Actinomycosis is generally not diagnosed until the chronic phase. […] The bacteria infects by inhibiting host defenses and/or reducing partial pressures of oxygen. […] The organism is not virulent and only invades the body to cause deeper infections when there is tissue injury and a subsequent break in the normal mucosal barrier. Infection is mostly polymicrobial, with as many as 5 to 10 other bacterial species present. The infection is established with the help of a companion bacteria by inhibiting host defenses, reducing oxygen tension, or by producing a toxin that facilitates the inoculation of actinomycoses.

• #24 The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era

  https://www.mdpi.com/2079-6382/9/8/524

  The optimal temperature for growth of Actinomyces, namely 30 °C to 37 °C, suggests a primary human and animal source of bacteria. […] The identification and differentiation of the anaerobic Gram-positive rods and species belonging to the genus Actinomyces may cause major troubles for clinical microbiology laboratories in terms of labor and the time-consuming nature of the process when conventional (biochemical reaction-based) methods are used. […] Most infections with Actinomyces spp. are polymicrobial and members of the Streptococcus genus are the most commonly associated organisms. […] They act synergistically by inhibiting host defence mechanisms and reducing oxygen tension in the affected tissue, which enhances growth of Actinomyces spp. […] The pathogenesis of primary bladder actinomycosis is unclear, but could be due to cryptic locations, and usually mimics bladder carcinoma; the lesions may invade adjacent organs such as the uterus or the sigmoid colon.

• #25 The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era

  https://www.mdpi.com/2079-6382/9/8/524

  The optimal temperature for growth of Actinomyces, namely 30 °C to 37 °C, suggests a primary human and animal source of bacteria. […] The identification and differentiation of the anaerobic Gram-positive rods and species belonging to the genus Actinomyces may cause major troubles for clinical microbiology laboratories in terms of labor and the time-consuming nature of the process when conventional (biochemical reaction-based) methods are used. […] Most infections with Actinomyces spp. are polymicrobial and members of the Streptococcus genus are the most commonly associated organisms. […] They act synergistically by inhibiting host defence mechanisms and reducing oxygen tension in the affected tissue, which enhances growth of Actinomyces spp. […] The pathogenesis of primary bladder actinomycosis is unclear, but could be due to cryptic locations, and usually mimics bladder carcinoma; the lesions may invade adjacent organs such as the uterus or the sigmoid colon.

• #26

  https://step2.medbullets.com/infectious-dis/121815/actinomycosis

  anaerobic environment in abscess cavities allow the bacteria to flourish […] Actinomyces israelii is an anaerobic, branching, filamentous gram + rod […] produces yellow sulfur-colored granules […] transmission occurs through direct contact with bacteria.

• #27 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Other bacterial species concomitantly present have been designated as companion organisms. They may serve as copathogens by aiding in the inhibition of host defenses or by reducing oxygen tension. The difficulty in establishing an animal model of infection with Actinomyces alone and enhancement of infection by coinoculation of E. corrodens support the concept that additional organisms are important for the initiation of infection. Furthermore, coaggregation of Actinomyces and Streptococcus spp. results in increased resistance to phagocytosis and killing. […] An acute inflammatory phase manifesting with a painful cellulitic reaction is occasionally observed with oral-cervicofacial disease or with soft tissue infection elsewhere in the body. The chronic phase of this disease is more often seen. Classic disease is characterized by a densely fibrotic lesion that undergoes slow, contiguous spread that ignores tissue planes. However, the factor(s) responsible for the unique pathogenesis of this disease remain undefined.

• #28 Actinomycosis: Diagnosis, Clinical Features and Treatment | IntechOpen

  https://www.intechopen.com/chapters/82972

  Actinomycosis is a filamentous bacterium that forms part of the normal human flora of the gastrointestinal, oropharynx and female genitalia. This indolent infection is characterized by abscess formation, widespread granulomatous disease, fibrosis, cavitary lung lesions and mass-like consolidations, simulating an active malignancy or systemic inflammatory diseases. The pathogenic characteristics of Actinomycosis, its capability to disseminate and grow in different environments and tissues, and its indolent and resistant presentation, has allowed this organism to confuse the clinician before obtaining a diagnosis and start treatment. The pathological damage cause by these organisms are secondary to direct tissue invasion and damage by the bacterial population. Also, actinomyces is often found cohabitating with other bacteria as Eikenella, Enterobacteriaceace, and species of Fusobacterium, Bacteroides, Capnocytophagia, Staphylococci, and Streptococci. It has been always a question of how those other organisms contribute to the pathogenesis of actinomycosis. It is believed that the cohabitant bacterias create an ecosystem that facilitates bacterial spread and growth of the actinomyces.

• #29

  https://journals.lww.com/md-journal/fulltext/2016/06140/clinical_features_of_actinomycosis__a.61.aspx

  Presence of Actinomyces in culture of bronchopulmonary secretions can be misleading because coexistence of actinomycosis with tuberculosis or neoplasm is possible, leading to a more challenging diagnosis and treatment of thoracic actinomycosis. In our study, failure to isolate the organism was 42%, which is consistent with other series. Twenty patients (71%) were diagnosed from surgical biopsy. As shown in our study, clinical symptoms and imaging lack of specificity to definite the disease, thus biopsy should be performed in cases when actinomycosis is considered as differential diagnosis. […] The proportion (46%) and composition of concomitant microbial flora were consistent with the literature. Since isolation of Actinomyces species from polymicrobial infections is frequent, they must be assumed to contribute to the pathogenic processes. Concomitant organisms are considered to synergistically enhance the infectious process. Treatment recommendations are based on small case series and in vivo studies, as no randomized controlled studies have evaluated antibiotic regimens. Two-thirds of patients were treated with amoxicillin. There is no consensus over the utilization of a lactamase inhibitor, which offers additional cover against potential coisolates.

• #30 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Other bacterial species concomitantly present have been designated as companion organisms. They may serve as copathogens by aiding in the inhibition of host defenses or by reducing oxygen tension. The difficulty in establishing an animal model of infection with Actinomyces alone and enhancement of infection by coinoculation of E. corrodens support the concept that additional organisms are important for the initiation of infection. Furthermore, coaggregation of Actinomyces and Streptococcus spp. results in increased resistance to phagocytosis and killing. […] An acute inflammatory phase manifesting with a painful cellulitic reaction is occasionally observed with oral-cervicofacial disease or with soft tissue infection elsewhere in the body. The chronic phase of this disease is more often seen. Classic disease is characterized by a densely fibrotic lesion that undergoes slow, contiguous spread that ignores tissue planes. However, the factor(s) responsible for the unique pathogenesis of this disease remain undefined.

• #31 Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4094581/

  Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. […] The mechanism of immune response in actinomycosis remains unclear, but some factors, by altering this response, probably promote the disease. […] Once Actinomyces spp. have invaded tissues, they develop a chronic granulomatous infection characterized by the formation of tiny clumps, called sulfur granules because of their yellow color. […] These formations of 0.11 mm in diameter, composed of an internal tangle of mycelial fragments and a rosette of peripheral clubs, are stabilized by a protein-polysaccharide complex, which is supposed to provide a resistance mechanism to host defenses by inhibiting phagocytosis.

• #32 Actinomycosis: etiology, clinical features, diagnosis, treatment, and | IDR

  https://www.dovepress.com/actinomycosis-etiology-clinical-features-diagnosis-treatment-and-manag-peer-reviewed-fulltext-article-IDR

  Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. […] The mechanism of immune response in actinomycosis remains unclear, but some factors, by altering this response, probably promote the disease. […] Once Actinomyces spp. have invaded tissues, they develop a chronic granulomatous infection characterized by the formation of tiny clumps, called sulfur granules because of their yellow color. […] These formations of 0.11 mm in diameter, composed of an internal tangle of mycelial fragments and a rosette of peripheral clubs, are stabilized by a protein-polysaccharide complex, which is supposed to provide a resistance mechanism to host defenses by inhibiting phagocytosis.

• #33 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Other bacterial species concomitantly present have been designated as companion organisms. They may serve as copathogens by aiding in the inhibition of host defenses or by reducing oxygen tension. The difficulty in establishing an animal model of infection with Actinomyces alone and enhancement of infection by coinoculation of E. corrodens support the concept that additional organisms are important for the initiation of infection. Furthermore, coaggregation of Actinomyces and Streptococcus spp. results in increased resistance to phagocytosis and killing. […] An acute inflammatory phase manifesting with a painful cellulitic reaction is occasionally observed with oral-cervicofacial disease or with soft tissue infection elsewhere in the body. The chronic phase of this disease is more often seen. Classic disease is characterized by a densely fibrotic lesion that undergoes slow, contiguous spread that ignores tissue planes. However, the factor(s) responsible for the unique pathogenesis of this disease remain undefined.

• #34 Actinomyces/Actinomycosis | Concise Medical Knowledge

  https://www.lecturio.com/concepts/actinomyces-actinomycosis/

  The disease is caused when the organism is displaced even by minor trauma or procedure, allowing the organism to move beyond the mucosal barrier. […] Breaching the mucosal barrier and moving to areas with low oxygen (anaerobic environment) facilitate its multiplication. […] The bacteria take advantage of the mucosal break, invading neighboring tissues. […] Once Actinomyces infection is established, inflammatory response follows (suppurative and granulomatous). […] Infection spreads by creating sinuses that contain sulfur granules; these may drain into the surface. […] Pathogenesis of Actinomyces: When there is a breakdown of the mucosal barrier, Actinomyces from the oropharynx (which goes to respiratory areas), GI tract, and reproductive tract cause infection and spread to contiguous tissues while creating sinus tracts.

• #35 Actinomycosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482151/

  Actinomyces are gram-positive filamentous non-acid fast anaerobic to microaerophilic bacteria that typically colonize the human mouth, urogenital tract, and gastrointestinal tract but can cause an infection known as actinomycosis. The infection is usually granulomatous, suppurative, and may involve multiple sulfur-containing abscesses that form sinus tracts. Actinomycosis is generally not diagnosed until the chronic phase. […] The bacteria infects by inhibiting host defenses and/or reducing partial pressures of oxygen. […] The organism is not virulent and only invades the body to cause deeper infections when there is tissue injury and a subsequent break in the normal mucosal barrier. Infection is mostly polymicrobial, with as many as 5 to 10 other bacterial species present. The infection is established with the help of a companion bacteria by inhibiting host defenses, reducing oxygen tension, or by producing a toxin that facilitates the inoculation of actinomycoses.

• #36 Actinomycosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/211587-overview

  Actinomycosis is a subacute-to-chronic bacterial infection caused by filamentous, gram-positive, nonacid-fast, anaerobic-to-microaerophilic bacteria. It is characterized by contiguous spread, suppurative and granulomatous inflammation, and formation of multiple abscesses and sinus tracts that may discharge sulfur granules. […] Because these microorganisms are not virulent, they require a break in the integrity of the mucous membranes and the presence of devitalized tissue to invade deeper body structures and to cause human illness. […] Furthermore, actinomycosis is generally a polymicrobial infection, with isolates numbering as many as 5-10 bacterial species. Establishment of human infection may require the presence of such companion bacteria, which participate in the production of infection by elaborating a toxin or enzyme or by inhibiting host defenses. These companion bacteria appear to act as copathogens that enhance the relatively low invasiveness of actinomycetes.

• #37 Actinomycosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/211587-overview

  Once infection is established, the host mounts an intense inflammatory response (ie, suppurative, granulomatous), and fibrosis may then follow. Infection typically spreads contiguously, frequently ignoring tissue planes and invading surrounding tissues or organs. Ultimately, the infection produces draining sinus tracts. Hematogenous dissemination to distant organs may occur in any stage of actinomycosis, whereas lymphatic dissemination is unusual.

• #38 Actinomyces – Pathogenesis, Clinical Manifestation

  https://studymicrobio.com/actinomyces-pathogenesis-clinical-manifestation/

  Within diseased tissue, the Actinomyces form large masses of mycelia embedded in an amorphous protein-polysaccharide matrix and surrounded by gram-negative, weakly acid-fast, club-like structures. […] Once the infection is established it causes a draining sinus tract which contains, damaged tissue. Then Actinomyces bacteria disseminate by the blood circulation to distant organs. These mycelia masses are visible to the naked eye and are light yellow in color. They are called sulfur granules. […] In older lesions, sulfur granules may be dark brown and hardened (due to deposition and calcium phosphate). Actinomyces may colonize diseased tissue, such as lung cancer but sulfur granules are not seen.

• #39 Actinomycosis: Microbiology, epidemiology, clinical manifestations, and diagnosis – UpToDate

  https://www.uptodate.com/contents/actinomycosis-microbiology-epidemiology-clinical-manifestations-and-diagnosis

  Actinomycosis is an infection characterized by abscess formation, induration, draining sinus tracts, fistulae, and tissue fibrosis. […] The microbiology, pathophysiology, epidemiology, clinical sites of infection, and diagnosis of actinomycosis will be reviewed here. […] A hallmark of actinomycosis is the tendency to spread without regard for anatomical barriers (including tissue planes or lymphatic drainage). This is often noted on imaging where a mass is seen aggressively crossing anatomic tissue planes. […] Actinomyces spp are noted for forming characteristic sulfur granules in infected tissue but not in vitro. The term „sulfur granule” is a misnomer, reflecting only the yellow color of the granule in pus, since they are not composed of any sulfur at all. The granules are actually discrete macroscopic grains of hard consistency, 100 to 1000 mcm in diameter, often visible to the naked eye or by microscopy with low magnification (10x). They are composed of an internal tangle of mycelial fragments and a radiating arrangement of eosinophilic peripheral clubs.

• #40 Actinomycosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/211587-overview

  Once infection is established, the host mounts an intense inflammatory response (ie, suppurative, granulomatous), and fibrosis may then follow. Infection typically spreads contiguously, frequently ignoring tissue planes and invading surrounding tissues or organs. Ultimately, the infection produces draining sinus tracts. Hematogenous dissemination to distant organs may occur in any stage of actinomycosis, whereas lymphatic dissemination is unusual.

• #41 Actinomycosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482151/

  Once mucosal barriers are breached, and infection is established, the human host responds by initiating an intense inflammatory response which is suppurative and granulomatous. The infection does not respect tissue planes and spreads contiguously. This results in draining sinus tracts, tiny yellow clumps called sulfur granules, and the result may be intense fibrosis of tissue. […] Hematogenous dissemination is extremely rare.

• #42 Actinomycosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/211587-overview

  Once infection is established, the host mounts an intense inflammatory response (ie, suppurative, granulomatous), and fibrosis may then follow. Infection typically spreads contiguously, frequently ignoring tissue planes and invading surrounding tissues or organs. Ultimately, the infection produces draining sinus tracts. Hematogenous dissemination to distant organs may occur in any stage of actinomycosis, whereas lymphatic dissemination is unusual.

• #43 The Korean Journal of Internal Medicine

  https://www.kjim.org/m/journal/view.php?number=8014

  Actinomycosis is an infectious disease caused by certain Actinomyces species. Actinomyces are Gram-positive, non-spore forming organisms characterized by obligate or facultative anaerobic rods that normally inhabit anaerobic niches of the human oral cavity. […] Actinomycosis is a chronic suppurative infection which infiltrates mucosa-associated tissues. […] A pivotal step in the pathogenesis of actinomycosis is disruption of the mucosal barrier. […] The hallmark of actinomycosis is the formation of the yellow sulfur granules. […] Actinomycosis has been called the most misdiagnosed disease and there is no disease which is so often missed by experienced clinicians. […] The radiographic findings are dependent on the chronicity of the disease. […] There are a few case reports of endobronchial actinomycosis. […] The treatment of choice for infection with Actinomyces is penicillin.

• #44 Actinomycosis: Microbiology, epidemiology, clinical manifestations, and diagnosis – UpToDate

  https://www.uptodate.com/contents/actinomycosis-microbiology-epidemiology-clinical-manifestations-and-diagnosis

  Actinomycosis is an infection characterized by abscess formation, induration, draining sinus tracts, fistulae, and tissue fibrosis. […] The microbiology, pathophysiology, epidemiology, clinical sites of infection, and diagnosis of actinomycosis will be reviewed here. […] A hallmark of actinomycosis is the tendency to spread without regard for anatomical barriers (including tissue planes or lymphatic drainage). This is often noted on imaging where a mass is seen aggressively crossing anatomic tissue planes. […] Actinomyces spp are noted for forming characteristic sulfur granules in infected tissue but not in vitro. The term „sulfur granule” is a misnomer, reflecting only the yellow color of the granule in pus, since they are not composed of any sulfur at all. The granules are actually discrete macroscopic grains of hard consistency, 100 to 1000 mcm in diameter, often visible to the naked eye or by microscopy with low magnification (10x). They are composed of an internal tangle of mycelial fragments and a radiating arrangement of eosinophilic peripheral clubs.

• #45 Actinomycosis: Microbiology, epidemiology, clinical manifestations, and diagnosis – UpToDate

  https://www.uptodate.com/contents/actinomycosis-microbiology-epidemiology-clinical-manifestations-and-diagnosis

  Actinomycosis is an infection characterized by abscess formation, induration, draining sinus tracts, fistulae, and tissue fibrosis. […] The microbiology, pathophysiology, epidemiology, clinical sites of infection, and diagnosis of actinomycosis will be reviewed here. […] A hallmark of actinomycosis is the tendency to spread without regard for anatomical barriers (including tissue planes or lymphatic drainage). This is often noted on imaging where a mass is seen aggressively crossing anatomic tissue planes. […] Actinomyces spp are noted for forming characteristic sulfur granules in infected tissue but not in vitro. The term „sulfur granule” is a misnomer, reflecting only the yellow color of the granule in pus, since they are not composed of any sulfur at all. The granules are actually discrete macroscopic grains of hard consistency, 100 to 1000 mcm in diameter, often visible to the naked eye or by microscopy with low magnification (10x). They are composed of an internal tangle of mycelial fragments and a radiating arrangement of eosinophilic peripheral clubs.

• #46 Actinomyces – Pathogenesis, Clinical Manifestation

  https://studymicrobio.com/actinomyces-pathogenesis-clinical-manifestation/

  Actinomyces spp. causes a chronic disease characterized by multiple abscesses and granulomata, tissue destruction, extensive fibrosis, and the formation of sinuses. […] Actinomyces spp. is normal floras of the oral cavity, low GI tract, and female genital tract. It causes the company of bacteria for infection or open to cause infection such as Bifidobacterium, Actinobacillus, Bacteroides, Eikenella, Haemophilus, Fusobacterium, Staphylococcus, Streptococcus, etc. These bacteria help in the initiation of infection by producing cytotoxins, and enzymes and by inhibiting host immunity. […] Once Actinomyces invade the tissue, they develop a chronic granulomatous infection characterized by the formation of tiny clumps known as sulfur granules because of their yellow color, size of granules 0.1-1mm in diameter, and composed of an internal tangle of mycelium filament, and a rosette of peripheral clubs. These granules are stabilized by a protein-polysaccharide complex which provides aid to host defense by inhibiting phagocytosis.

• #47 Actinomycosis: Microbiology, epidemiology, clinical manifestations, and diagnosis – UpToDate

  https://www.uptodate.com/contents/actinomycosis-microbiology-epidemiology-clinical-manifestations-and-diagnosis

  Actinomycosis is an infection characterized by abscess formation, induration, draining sinus tracts, fistulae, and tissue fibrosis. […] The microbiology, pathophysiology, epidemiology, clinical sites of infection, and diagnosis of actinomycosis will be reviewed here. […] A hallmark of actinomycosis is the tendency to spread without regard for anatomical barriers (including tissue planes or lymphatic drainage). This is often noted on imaging where a mass is seen aggressively crossing anatomic tissue planes. […] Actinomyces spp are noted for forming characteristic sulfur granules in infected tissue but not in vitro. The term „sulfur granule” is a misnomer, reflecting only the yellow color of the granule in pus, since they are not composed of any sulfur at all. The granules are actually discrete macroscopic grains of hard consistency, 100 to 1000 mcm in diameter, often visible to the naked eye or by microscopy with low magnification (10x). They are composed of an internal tangle of mycelial fragments and a radiating arrangement of eosinophilic peripheral clubs.

• #48 Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4094581/

  Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. […] The mechanism of immune response in actinomycosis remains unclear, but some factors, by altering this response, probably promote the disease. […] Once Actinomyces spp. have invaded tissues, they develop a chronic granulomatous infection characterized by the formation of tiny clumps, called sulfur granules because of their yellow color. […] These formations of 0.11 mm in diameter, composed of an internal tangle of mycelial fragments and a rosette of peripheral clubs, are stabilized by a protein-polysaccharide complex, which is supposed to provide a resistance mechanism to host defenses by inhibiting phagocytosis.

• #49 Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4094581/

  Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. […] The mechanism of immune response in actinomycosis remains unclear, but some factors, by altering this response, probably promote the disease. […] Once Actinomyces spp. have invaded tissues, they develop a chronic granulomatous infection characterized by the formation of tiny clumps, called sulfur granules because of their yellow color. […] These formations of 0.11 mm in diameter, composed of an internal tangle of mycelial fragments and a rosette of peripheral clubs, are stabilized by a protein-polysaccharide complex, which is supposed to provide a resistance mechanism to host defenses by inhibiting phagocytosis.

• #50 Actinomycosis: etiology, clinical features, diagnosis, treatment, and | IDR

  https://www.dovepress.com/actinomycosis-etiology-clinical-features-diagnosis-treatment-and-manag-peer-reviewed-fulltext-article-IDR

  Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. […] The mechanism of immune response in actinomycosis remains unclear, but some factors, by altering this response, probably promote the disease. […] Once Actinomyces spp. have invaded tissues, they develop a chronic granulomatous infection characterized by the formation of tiny clumps, called sulfur granules because of their yellow color. […] These formations of 0.11 mm in diameter, composed of an internal tangle of mycelial fragments and a rosette of peripheral clubs, are stabilized by a protein-polysaccharide complex, which is supposed to provide a resistance mechanism to host defenses by inhibiting phagocytosis.

• #51 Actinomyces – Pathogenesis, Clinical Manifestation

  https://studymicrobio.com/actinomyces-pathogenesis-clinical-manifestation/

  Within diseased tissue, the Actinomyces form large masses of mycelia embedded in an amorphous protein-polysaccharide matrix and surrounded by gram-negative, weakly acid-fast, club-like structures. […] Once the infection is established it causes a draining sinus tract which contains, damaged tissue. Then Actinomyces bacteria disseminate by the blood circulation to distant organs. These mycelia masses are visible to the naked eye and are light yellow in color. They are called sulfur granules. […] In older lesions, sulfur granules may be dark brown and hardened (due to deposition and calcium phosphate). Actinomyces may colonize diseased tissue, such as lung cancer but sulfur granules are not seen.

• #52 Actinomyces bovis – Wikipedia

  https://en.wikipedia.org/wiki/Actinomyces_bovis

  The club-shapes, also called Spendore-Hoeppli proteins, seen on histological slides are the result of the bacteria being encased in a calcium-phosphate protein complex, as the host attempts to wall off the infection.[17] […] Another diagnostic feature is the presence of „sulfur” granules,[6] which is pathognomonic for actinomycosis.[17]

• #53 Actinomycosis: etiology, clinical features, diagnosis, treatment, and management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4094581/

  Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. […] The mechanism of immune response in actinomycosis remains unclear, but some factors, by altering this response, probably promote the disease. […] Once Actinomyces spp. have invaded tissues, they develop a chronic granulomatous infection characterized by the formation of tiny clumps, called sulfur granules because of their yellow color. […] These formations of 0.11 mm in diameter, composed of an internal tangle of mycelial fragments and a rosette of peripheral clubs, are stabilized by a protein-polysaccharide complex, which is supposed to provide a resistance mechanism to host defenses by inhibiting phagocytosis.

• #54 Actinomycosis: etiology, clinical features, diagnosis, treatment, and | IDR

  https://www.dovepress.com/actinomycosis-etiology-clinical-features-diagnosis-treatment-and-manag-peer-reviewed-fulltext-article-IDR

  Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. […] The mechanism of immune response in actinomycosis remains unclear, but some factors, by altering this response, probably promote the disease. […] Once Actinomyces spp. have invaded tissues, they develop a chronic granulomatous infection characterized by the formation of tiny clumps, called sulfur granules because of their yellow color. […] These formations of 0.11 mm in diameter, composed of an internal tangle of mycelial fragments and a rosette of peripheral clubs, are stabilized by a protein-polysaccharide complex, which is supposed to provide a resistance mechanism to host defenses by inhibiting phagocytosis.

• #55 Perianal Actinomycosis: A Surgeon’s Perspective and Review of Literature

  https://coloproctol.org/journal/view.php?number=1879

  Actinomycosis is a serious suppurative, bacterial infection caused by the gram-positive anaerobic Actinomyces species. Primary perianal actinomycosis is rare and challenging for the colorectal surgeon. […] The pathogenesis of perianal suppuration is currently attributed to those anal crypts getting blocked by debris or stool, which subsequently results in cryptitis and formation of abscess. […] The exact mechanism that leads to overt disease is still unknown, as actinomycosis occurs in both immune-competent and immune-compromised patients. […] The anorectal form usually begins in an anal crypt where it evolves as a chronic bacterial infection that is characterized by slowly progressing suppurative fibrosing inflammation, development of draining sinus tracts that may discharge characteristic sulfur granules and direct dissemination via adjacent tissues.

• #56 Actinomycosis: Diagnosis, Clinical Features and Treatment | IntechOpen

  https://www.intechopen.com/chapters/82972

  The condition is usually considered as infrequent, however the epidemiologic data is very limited and probable underreported. Infection involving the cervicofacial area is the most commonly known, representing 60% of the cases. The organism can invade any abdominal tissue, most commonly the bowel, causing appendicitis in 65% of the cases, but also, gastrointestinal perforation and upper and lower bowel obstruction have been reported. The third most common presentation is thoracic actinomycosis (15-20% of the reported cases). Infection develop after aspiration of the oropharyngeal secretions or perforation of the esophagus. Some cases develop from progression from cervicofacial or abdominal actinomycosis, or after hematogenous spread in disseminated disease. […] Actinomycosis is considered an endogenous infection. This organism can affect immunocompromise and immunocompetent hosts. Risk factors associated with the acquisition of actinomycosis include: male sex between 20 and 60 years old, diabetics, poor oral hygiene, implanted foreign bodies as occurs during aspiration, or intrauterine implantable contraceptive device (IUD). Also, the use of immunosuppressive therapy, as systemic steroids or chemotherapy, has also being identified as possible risk factor for localized and disseminated infection. Other identified factors to acquire the infection include history of HIV, active hematogenous and solid malignancy, organ transplant, alcohol abuse, and accidental or intentional tissue trauma, as tissue radiation or surgery.

• #57 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Foreign bodies appear to facilitate infection. This association has been most commonly observed with IUCDs and pelvic actinomycosis. Associations with actinomycosis and foreign material elsewhere are less strong. Aspirated, ingested, or implanted foreign bodies may contribute to pathogenesis via facilitating the growth and survival, and biofilm formation. […] Cases of actinomycosis have been described in the settings of steroid use, antiTNF- agents, bisphosphonate treatment, radionecrosis, acute leukemia during chemotherapy, organ transplantation, common variable immunodeficiency, chronic granulomatous disease, and human immunodeficiency virus (HIV) infection. Ulcerative mucosal lesions (herpes simplex virus, cytomegalovirus, chemotherapy) and abnormalities in host defenses likely facilitated the development of actinomycosis in some HIV-associated cases; however, it remains unclear which arm(s) of the host defense are critical in preventing or controlling this infection and the degree to which the incidence of infection is increased in these settings.

• #58 Actinomycosis: Diagnosis, Clinical Features and Treatment | IntechOpen

  https://www.intechopen.com/chapters/82972

  The condition is usually considered as infrequent, however the epidemiologic data is very limited and probable underreported. Infection involving the cervicofacial area is the most commonly known, representing 60% of the cases. The organism can invade any abdominal tissue, most commonly the bowel, causing appendicitis in 65% of the cases, but also, gastrointestinal perforation and upper and lower bowel obstruction have been reported. The third most common presentation is thoracic actinomycosis (15-20% of the reported cases). Infection develop after aspiration of the oropharyngeal secretions or perforation of the esophagus. Some cases develop from progression from cervicofacial or abdominal actinomycosis, or after hematogenous spread in disseminated disease. […] Actinomycosis is considered an endogenous infection. This organism can affect immunocompromise and immunocompetent hosts. Risk factors associated with the acquisition of actinomycosis include: male sex between 20 and 60 years old, diabetics, poor oral hygiene, implanted foreign bodies as occurs during aspiration, or intrauterine implantable contraceptive device (IUD). Also, the use of immunosuppressive therapy, as systemic steroids or chemotherapy, has also being identified as possible risk factor for localized and disseminated infection. Other identified factors to acquire the infection include history of HIV, active hematogenous and solid malignancy, organ transplant, alcohol abuse, and accidental or intentional tissue trauma, as tissue radiation or surgery.

• #59 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Foreign bodies appear to facilitate infection. This association has been most commonly observed with IUCDs and pelvic actinomycosis. Associations with actinomycosis and foreign material elsewhere are less strong. Aspirated, ingested, or implanted foreign bodies may contribute to pathogenesis via facilitating the growth and survival, and biofilm formation. […] Cases of actinomycosis have been described in the settings of steroid use, antiTNF- agents, bisphosphonate treatment, radionecrosis, acute leukemia during chemotherapy, organ transplantation, common variable immunodeficiency, chronic granulomatous disease, and human immunodeficiency virus (HIV) infection. Ulcerative mucosal lesions (herpes simplex virus, cytomegalovirus, chemotherapy) and abnormalities in host defenses likely facilitated the development of actinomycosis in some HIV-associated cases; however, it remains unclear which arm(s) of the host defense are critical in preventing or controlling this infection and the degree to which the incidence of infection is increased in these settings.

• #60 Actinomycosis: Diagnosis, Clinical Features and Treatment | IntechOpen

  https://www.intechopen.com/chapters/82972

  The condition is usually considered as infrequent, however the epidemiologic data is very limited and probable underreported. Infection involving the cervicofacial area is the most commonly known, representing 60% of the cases. The organism can invade any abdominal tissue, most commonly the bowel, causing appendicitis in 65% of the cases, but also, gastrointestinal perforation and upper and lower bowel obstruction have been reported. The third most common presentation is thoracic actinomycosis (15-20% of the reported cases). Infection develop after aspiration of the oropharyngeal secretions or perforation of the esophagus. Some cases develop from progression from cervicofacial or abdominal actinomycosis, or after hematogenous spread in disseminated disease. […] Actinomycosis is considered an endogenous infection. This organism can affect immunocompromise and immunocompetent hosts. Risk factors associated with the acquisition of actinomycosis include: male sex between 20 and 60 years old, diabetics, poor oral hygiene, implanted foreign bodies as occurs during aspiration, or intrauterine implantable contraceptive device (IUD). Also, the use of immunosuppressive therapy, as systemic steroids or chemotherapy, has also being identified as possible risk factor for localized and disseminated infection. Other identified factors to acquire the infection include history of HIV, active hematogenous and solid malignancy, organ transplant, alcohol abuse, and accidental or intentional tissue trauma, as tissue radiation or surgery.

• #61 Actinomycosis: Diagnosis, Clinical Features and Treatment | IntechOpen

  https://www.intechopen.com/chapters/82972

  The condition is usually considered as infrequent, however the epidemiologic data is very limited and probable underreported. Infection involving the cervicofacial area is the most commonly known, representing 60% of the cases. The organism can invade any abdominal tissue, most commonly the bowel, causing appendicitis in 65% of the cases, but also, gastrointestinal perforation and upper and lower bowel obstruction have been reported. The third most common presentation is thoracic actinomycosis (15-20% of the reported cases). Infection develop after aspiration of the oropharyngeal secretions or perforation of the esophagus. Some cases develop from progression from cervicofacial or abdominal actinomycosis, or after hematogenous spread in disseminated disease. […] Actinomycosis is considered an endogenous infection. This organism can affect immunocompromise and immunocompetent hosts. Risk factors associated with the acquisition of actinomycosis include: male sex between 20 and 60 years old, diabetics, poor oral hygiene, implanted foreign bodies as occurs during aspiration, or intrauterine implantable contraceptive device (IUD). Also, the use of immunosuppressive therapy, as systemic steroids or chemotherapy, has also being identified as possible risk factor for localized and disseminated infection. Other identified factors to acquire the infection include history of HIV, active hematogenous and solid malignancy, organ transplant, alcohol abuse, and accidental or intentional tissue trauma, as tissue radiation or surgery.

• #62 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Foreign bodies appear to facilitate infection. This association has been most commonly observed with IUCDs and pelvic actinomycosis. Associations with actinomycosis and foreign material elsewhere are less strong. Aspirated, ingested, or implanted foreign bodies may contribute to pathogenesis via facilitating the growth and survival, and biofilm formation. […] Cases of actinomycosis have been described in the settings of steroid use, antiTNF- agents, bisphosphonate treatment, radionecrosis, acute leukemia during chemotherapy, organ transplantation, common variable immunodeficiency, chronic granulomatous disease, and human immunodeficiency virus (HIV) infection. Ulcerative mucosal lesions (herpes simplex virus, cytomegalovirus, chemotherapy) and abnormalities in host defenses likely facilitated the development of actinomycosis in some HIV-associated cases; however, it remains unclear which arm(s) of the host defense are critical in preventing or controlling this infection and the degree to which the incidence of infection is increased in these settings.

• #63 Actinomycosis | SpringerLink

  https://link.springer.com/10.1007%2F978-3-642-02202-9_98

  The genus Actinomyces consists of a heterogeneous group of gram-positive, non-spore forming catalase-negative pleomorphic rods that form a significant component of the commensal microflora of the oral, gastrointestinal, and female genital tracts and that are generally of low pathogenicity. Actinomyces species may invade via damaged mucosa, leading to bacteremia and systemic infections in both healthy individuals and immunocompromised patients. […] Actinomycosis is a catalase-negative infection and important to consider in chronic granulomatous disease (CGD). […] Of the 14 human actinomyces species, six may cause disease in humans, including the facultative anaerobic A. israelli, A. naeslundii, A. odontolyticus, A. visosus, A. meyeri, and A. gerencseriae. Actinomyces are fastidious bacteria that require cultures enriched with brain-heart infusion media, may be aided in growth by an atmosphere of 610% ambient CO2, and grow best at 37C.

• #64 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Foreign bodies appear to facilitate infection. This association has been most commonly observed with IUCDs and pelvic actinomycosis. Associations with actinomycosis and foreign material elsewhere are less strong. Aspirated, ingested, or implanted foreign bodies may contribute to pathogenesis via facilitating the growth and survival, and biofilm formation. […] Cases of actinomycosis have been described in the settings of steroid use, antiTNF- agents, bisphosphonate treatment, radionecrosis, acute leukemia during chemotherapy, organ transplantation, common variable immunodeficiency, chronic granulomatous disease, and human immunodeficiency virus (HIV) infection. Ulcerative mucosal lesions (herpes simplex virus, cytomegalovirus, chemotherapy) and abnormalities in host defenses likely facilitated the development of actinomycosis in some HIV-associated cases; however, it remains unclear which arm(s) of the host defense are critical in preventing or controlling this infection and the degree to which the incidence of infection is increased in these settings.

• #65

  https://journals.lww.com/dcrjournal/abstract/2005/48030/actinomycosis,_a_rare_and_unsuspected_cause_of.24.aspx

  Primary perianal actinomycosis is rare. Sporadic cases, with lesions varying in extent have been reported. The infection is caused by the bacterium Actinomyces, which often is a saprophyte. Male gender and diabetes are risk factors, but the exact pathogenic mechanism remains speculative. […] It is concluded that perianal actinomycosis can occur in the absence of risk factors and that early diagnosis requires a high degree of suspicion. An infection with Actinomyces should be suspected in the presence of lesions containing watery purulent material with sulfur granules. The indication for extended antibiotherapy combined with sphincter damaging surgery may need to be revised in the presence of early detection.

• #66 Actinomycosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/211587-overview

  Once infection is established, the host mounts an intense inflammatory response (ie, suppurative, granulomatous), and fibrosis may then follow. Infection typically spreads contiguously, frequently ignoring tissue planes and invading surrounding tissues or organs. Ultimately, the infection produces draining sinus tracts. Hematogenous dissemination to distant organs may occur in any stage of actinomycosis, whereas lymphatic dissemination is unusual.

• #67 SciELO Brazil – Actinomycosis in the maxilla of a young asymptomatic patient: unusual case report Actinomycosis in the maxilla of a young asymptomatic patient: unusual case report

  https://www.scielo.br/j/rgo/a/LdSs66RdnQG5nzQBFxJGQVm/

  In cases of actinomycosis in the apical region, the source of infection can be intraradicular biofilm or extraradicular bacterial aggregations, such as sulfur granules. […] The diagnosis of infection is made based on clinical manifestations, associated with microbiological and histopathological findings. […] Microscopically, it is possible to observe a zone of granulation tissue that consists of collagen fibers around central purulent loculations containing abundant neutrophils. […] In the central part, bacterial colonies are observed, with small basophilic heads called conidiophores towards the center and thin eosinophilic hyphae radiating outwards towards the periphery. […] For the treatment of actinomycosis, antibiotic therapy with 6 to 12 million IU penicillin is recommended, which can vary from four weeks to one year, based on the severity of the disease. […] Surgical treatment without antibiotic therapy is associated with recurrence.

• #68 Diagnosis of Actinomycosis in the Physician’s Clinic | IntechOpen

  https://www.intechopen.com/chapters/82015

  Already established as being mainly an endogenous infection, in that the pathogenic Actinomyces species are commensals and normal inhabitants of the oropharynx, gastrointestinal tract, and female genital tracts in humans. It thus follows that pathogenicity in the abdominopelvic region would involve a breach in intestinal or internal genital mucosal lining, thus affecting the local structures and organs. Causes would therefore include penetrating trauma, gastrointestinal or gynaecological surgery, neoplasia, and foreign bodies in the gastrointestinal tract or genitourinary tract, with or without erosion through the mucosal barrier. […] Actinomyces spp. reside on their respective mucosal surfaces of the anatomical sites that they inhabit. A gain into deeper adjacent tissues require a disruption of the mucosal surface usually following some mechanical factor such as trauma or surgery.

• #69 Cervicofacial actinomycosis: important considerations on a mimicking disease

  https://www.redalyc.org/journal/4215/421564337008/html/

  Actinomyces are part of the normal oral microbiota, where they are commensals of periodontal pockets, caries, dental plaque, calculus and gingival crevices. Nevertheless, they can become pathogenic by accessing the oral submucosa through an open door. Mucosal breaks play an important role in providing access to a microaerophilic environment favorable for infection. […] Actinomycosis occurs almost exclusively by direct invasion, and rarely through hematogenous spread. […] Actinomyces are commensal microorganisms found in particular sites of oral cavity. Oral mucosa breaks act as an open door to a microenvironment favorable for infection, leading to disease onset. […] Actinomyces are sensitive to beta-lactams (penicillin G IV), being these agents the first treatment choice. […] The efficacy of the therapy can be related not only to its direct effect on Actinomyces israelli, but also to antimicrobial suppression of the other organisms that are involved in the metabolic ecosystem enabling Actinomyces to flourish.

• #70 Actinomycosis: Diagnosis, Clinical Features and Treatment | IntechOpen

  https://www.intechopen.com/chapters/82972

  Actinomycosis is a filamentous bacterium that forms part of the normal human flora of the gastrointestinal, oropharynx and female genitalia. This indolent infection is characterized by abscess formation, widespread granulomatous disease, fibrosis, cavitary lung lesions and mass-like consolidations, simulating an active malignancy or systemic inflammatory diseases. The pathogenic characteristics of Actinomycosis, its capability to disseminate and grow in different environments and tissues, and its indolent and resistant presentation, has allowed this organism to confuse the clinician before obtaining a diagnosis and start treatment. The pathological damage cause by these organisms are secondary to direct tissue invasion and damage by the bacterial population. Also, actinomyces is often found cohabitating with other bacteria as Eikenella, Enterobacteriaceace, and species of Fusobacterium, Bacteroides, Capnocytophagia, Staphylococci, and Streptococci. It has been always a question of how those other organisms contribute to the pathogenesis of actinomycosis. It is believed that the cohabitant bacterias create an ecosystem that facilitates bacterial spread and growth of the actinomyces.

• #71 An overview of thoracic actinomycosis: CT features | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1007/s13244-012-0205-9

  Thoracic actinomycosis is an uncommon, chronic suppurative bacterial infection caused by actinomyces species, especially Actinomyces israelii. […] A higher incidence of pulmonary actinomycosis has been reported in patients with underlying respiratory disorders such as emphysema, chronic bronchitis, bronchiectasis and any condition in which the lung parenchyma are destroyed by a previous infection. […] Actinomyces has a tendency to colonise devitalised tissue. Actinomyces spp. colonise in the dilated bronchi and exacerbate pre-existing bronchial inflammation and bronchiectasis. […] The pathogenesis of co-infection is a synergistic effect: oxygen deprivation due to other bacteria creates an anaerobic milieu in which actinomyces thrive. […] Actinomyces seem to colonise devitalised tissue and secondarily invade pre-existing broncholiths. Subsequent inflammation enlarges the endobronchial lesion, which leads to obstructive pneumonia. […] The organisms produce proteolytic enzymes, and peripheral pneumonia tends to involve the pleura, producing empyema, and invade the chest wall with involvement of bones such as the ribs or vertebrae.

• #72 Actinomycosis of the reproductive organs – Own experience

  https://www.oatext.com/actinomycosis-of-the-reproductive-organs-own-experience.php

  The abdominal-pelvic form of actinomycosis usually manifests as slow-growing inflammatory foci, most often in the large intestine, caecum, appendix, urinary tract, abdominal wall, perianal area, in the ovaries, and fallopian tubes. Clinical manifestations are often nonspecific. Patients report abdominal pain, malaise, excessive discharge from the genital tract, bleeding or spotting may also occur. General symptoms include fever, weight loss, lack of appetite, nausea, and vomiting. The complete clinical picture of abdominal and pelvic actinomycosis can mimic a tumor growth, often suspected of being far advanced. […] Proper long-term antibiotic therapy and surgical treatment offer chances for therapeutic success in the treatment of actinomycosis. Only accurate diagnosis and treatment can prevent complications and disease relapses.

• #73 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic bacteria, primarily from the genus Actinomyces, that normally colonize the mouth, colon, and vagina. Disruption of mucosa may lead to infection of virtually any site. […] A pivotal step in the pathogenesis of actinomycosis is disruption of mucosal or epithelial barriers enabling entry of colonizing Actinomyces or related genera. Oral and cervicofacial disease is frequently associated with dental procedures, trauma, oral surgery, head and neck radiotherapy, or oncologic surgical procedures. Pulmonary infections often arise in the setting of aspiration, and abdominal infection is usually preceded by conditions that result in loss of mucosal integrity, such as surgery, diverticulitis, appendicitis, or foreign bodies (e.g., fish bones). Recognition of factors that enable bacterial entry into deep tissues, however, may be absent. The lack of such a history should not prevent consideration of this disease when the clinical circumstance is appropriate.

• #74 The epidemiology, clinical presentation and treatment outcomes in CNS actinomycosis: a systematic review of reported cases | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-023-02744-z

  CNS actinomycosis is a rare chronic suppurative infection with non-specific clinical features. Diagnosis is difficult due to its similarity to malignancy, nocardiosis and other granulomatous diseases. […] Actinomycosis is a rare, subacute to chronic granulomatous infection caused by gram-positive anaerobic Actinomyces species. […] Actinomycosis is usually described as an indolent infection with protean manifestations; however, CNS involvement is the most severe form of actinomycosis. […] Actinomycosis is usually considered a disease with low virulence. CNS spread primarily depends on mucosal breach and contiguous spread from cervicofacial areas, skull osteomyelitis and less commonly from hematogenous spread from distant foci (lungs, abdomen, pelvis). […] The diagnosis of actinomycosis is based on a constellation of histopathological features and microbiological isolation of the organism.

• #75 The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era

  https://www.mdpi.com/2079-6382/9/8/524

  Actinomycosis is a chronic, suppurative, granulomatous infectious disease, caused by different species of Actinomyces bacteria. […] The suspected causative agent in these human infections, originally termed Streptothrix israelii (currently Actinomyces israelii) was correctly identified later in 1896 by Kruse. […] The genomic evolution of the members of the family Actinomycetaceae is very dynamic, some studies observed that mutations or loss of genes in the species in the family contribute to changes in the microbial behavior and habitat preferences. […] The majority of species belong to the cluster that includes A. bovis, while the other two clusters, which include Actinomyces neuii and Actinomyces hordeovulneris should be investigated further to determine if they warrant proposal as novel genera.

• #76 The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era

  https://www.mdpi.com/2079-6382/9/8/524

  Actinomycosis is a chronic, suppurative, granulomatous infectious disease, caused by different species of Actinomyces bacteria. […] The suspected causative agent in these human infections, originally termed Streptothrix israelii (currently Actinomyces israelii) was correctly identified later in 1896 by Kruse. […] The genomic evolution of the members of the family Actinomycetaceae is very dynamic, some studies observed that mutations or loss of genes in the species in the family contribute to changes in the microbial behavior and habitat preferences. […] The majority of species belong to the cluster that includes A. bovis, while the other two clusters, which include Actinomyces neuii and Actinomyces hordeovulneris should be investigated further to determine if they warrant proposal as novel genera.

• #77 The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era

  https://www.mdpi.com/2079-6382/9/8/524

  The description of novel bacterial species was further facilitated by the newfound interest in the characterization of the human microbiome. […] The name of the genus originates from the greek words: aktinos (ray) and mykes (fungus), which corresponds to the radial arrangement of the bacterial filaments (resembling hyphae) and the possession of reproductive asexual spores, typical for filamentous fungi. […] The traditional bacteriological cultivation and identification of Actinomyces strains from a sterile site or infected region may confirm the diagnosis of actinomycosis, but the isolation and identification of these bacteria only occurs in some cases. […] The success of culture is low, because of the growth inhibition of Actinomyces by other microorganisms, inadequate culture conditions or inadequate (i.e., short-term) incubation.

• #78 Effective Hyperbaric Oxygen Therapy For Actinomycosis TreatmentAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontResetSitemap

  https://hyperbaricoxygeninstitute.com/hyperbaric-oxygen-therapy-actinomycosis/

  Actinomycosis is a rare but serious infection caused by bacteria that can affect various parts of the body, including the head and neck, chest, and abdomen. […] Hyperbaric oxygen therapy (HBOT) is a well-established and effective adjunctive therapy for Actinomycosis. […] HBOT works by delivering high concentrations of oxygen to the body’s tissues, which in turn promotes tissue healing and repair. […] It does so by increasing the amount of oxygen dissolved in the blood, creating hyperoxic conditions that promote angiogenesis, stimulate fibroblast proliferation, and enhance the white blood cell’s ability to fight infections. […] The mechanism of action of HBOT in treating Actinomycosis involves the delivery of high levels of oxygen to the tissues affected by the infection. This helps promote tissue repair and regeneration, enhances the immune response, and inhibits the growth of anaerobic bacteria responsible for the infection.

• #79 Effective Hyperbaric Oxygen Therapy For Actinomycosis TreatmentAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontResetSitemap

  https://hyperbaricoxygeninstitute.com/hyperbaric-oxygen-therapy-actinomycosis/

  Actinomycosis is a rare but serious infection caused by bacteria that can affect various parts of the body, including the head and neck, chest, and abdomen. […] Hyperbaric oxygen therapy (HBOT) is a well-established and effective adjunctive therapy for Actinomycosis. […] HBOT works by delivering high concentrations of oxygen to the body’s tissues, which in turn promotes tissue healing and repair. […] It does so by increasing the amount of oxygen dissolved in the blood, creating hyperoxic conditions that promote angiogenesis, stimulate fibroblast proliferation, and enhance the white blood cell’s ability to fight infections. […] The mechanism of action of HBOT in treating Actinomycosis involves the delivery of high levels of oxygen to the tissues affected by the infection. This helps promote tissue repair and regeneration, enhances the immune response, and inhibits the growth of anaerobic bacteria responsible for the infection.

• #80 Effective Hyperbaric Oxygen Therapy For Actinomycosis TreatmentAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontResetSitemap

  https://hyperbaricoxygeninstitute.com/hyperbaric-oxygen-therapy-actinomycosis/

  Actinomycosis is a rare but serious infection caused by bacteria that can affect various parts of the body, including the head and neck, chest, and abdomen. […] Hyperbaric oxygen therapy (HBOT) is a well-established and effective adjunctive therapy for Actinomycosis. […] HBOT works by delivering high concentrations of oxygen to the body’s tissues, which in turn promotes tissue healing and repair. […] It does so by increasing the amount of oxygen dissolved in the blood, creating hyperoxic conditions that promote angiogenesis, stimulate fibroblast proliferation, and enhance the white blood cell’s ability to fight infections. […] The mechanism of action of HBOT in treating Actinomycosis involves the delivery of high levels of oxygen to the tissues affected by the infection. This helps promote tissue repair and regeneration, enhances the immune response, and inhibits the growth of anaerobic bacteria responsible for the infection.

• #81 Effective Hyperbaric Oxygen Therapy For Actinomycosis TreatmentAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontResetSitemap

  https://hyperbaricoxygeninstitute.com/hyperbaric-oxygen-therapy-actinomycosis/

  Actinomycosis is a rare but serious infection caused by bacteria that can affect various parts of the body, including the head and neck, chest, and abdomen. […] Hyperbaric oxygen therapy (HBOT) is a well-established and effective adjunctive therapy for Actinomycosis. […] HBOT works by delivering high concentrations of oxygen to the body’s tissues, which in turn promotes tissue healing and repair. […] It does so by increasing the amount of oxygen dissolved in the blood, creating hyperoxic conditions that promote angiogenesis, stimulate fibroblast proliferation, and enhance the white blood cell’s ability to fight infections. […] The mechanism of action of HBOT in treating Actinomycosis involves the delivery of high levels of oxygen to the tissues affected by the infection. This helps promote tissue repair and regeneration, enhances the immune response, and inhibits the growth of anaerobic bacteria responsible for the infection.

• #82 Effective Hyperbaric Oxygen Therapy For Actinomycosis TreatmentAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontResetSitemap

  https://hyperbaricoxygeninstitute.com/hyperbaric-oxygen-therapy-actinomycosis/

  Research has shown that Actinomycosis patients who receive HBOT in combination with traditional antibiotic therapy have a higher chance of achieving full remission and experiencing a faster recovery time than those who only receive antibiotic treatment. […] Overall, HBOT is considered a safe and effective adjunctive therapy for Actinomycosis management, with few reported side effects when administered by qualified professionals.

• #83 The Korean Journal of Internal Medicine

  https://www.kjim.org/m/journal/view.php?number=8014

  Actinomycosis is an infectious disease caused by certain Actinomyces species. Actinomyces are Gram-positive, non-spore forming organisms characterized by obligate or facultative anaerobic rods that normally inhabit anaerobic niches of the human oral cavity. […] Actinomycosis is a chronic suppurative infection which infiltrates mucosa-associated tissues. […] A pivotal step in the pathogenesis of actinomycosis is disruption of the mucosal barrier. […] The hallmark of actinomycosis is the formation of the yellow sulfur granules. […] Actinomycosis has been called the most misdiagnosed disease and there is no disease which is so often missed by experienced clinicians. […] The radiographic findings are dependent on the chronicity of the disease. […] There are a few case reports of endobronchial actinomycosis. […] The treatment of choice for infection with Actinomyces is penicillin.

• #84 Agents of Actinomycosis – Clinical Tree

  https://clinicalpub.com/agents-of-actinomycosis/

  Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic bacteria, primarily from the genus Actinomyces, that normally colonize the mouth, colon, and vagina. Disruption of mucosa may lead to infection of virtually any site. […] A pivotal step in the pathogenesis of actinomycosis is disruption of mucosal or epithelial barriers enabling entry of colonizing Actinomyces or related genera. Oral and cervicofacial disease is frequently associated with dental procedures, trauma, oral surgery, head and neck radiotherapy, or oncologic surgical procedures. Pulmonary infections often arise in the setting of aspiration, and abdominal infection is usually preceded by conditions that result in loss of mucosal integrity, such as surgery, diverticulitis, appendicitis, or foreign bodies (e.g., fish bones). Recognition of factors that enable bacterial entry into deep tissues, however, may be absent. The lack of such a history should not prevent consideration of this disease when the clinical circumstance is appropriate.

• #85 Actinomycosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482151/

  Actinomyces are gram-positive filamentous non-acid fast anaerobic to microaerophilic bacteria that typically colonize the human mouth, urogenital tract, and gastrointestinal tract but can cause an infection known as actinomycosis. The infection is usually granulomatous, suppurative, and may involve multiple sulfur-containing abscesses that form sinus tracts. Actinomycosis is generally not diagnosed until the chronic phase. […] The bacteria infects by inhibiting host defenses and/or reducing partial pressures of oxygen. […] The organism is not virulent and only invades the body to cause deeper infections when there is tissue injury and a subsequent break in the normal mucosal barrier. Infection is mostly polymicrobial, with as many as 5 to 10 other bacterial species present. The infection is established with the help of a companion bacteria by inhibiting host defenses, reducing oxygen tension, or by producing a toxin that facilitates the inoculation of actinomycoses.

• #86 The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era

  https://www.mdpi.com/2079-6382/9/8/524

  The optimal temperature for growth of Actinomyces, namely 30 °C to 37 °C, suggests a primary human and animal source of bacteria. […] The identification and differentiation of the anaerobic Gram-positive rods and species belonging to the genus Actinomyces may cause major troubles for clinical microbiology laboratories in terms of labor and the time-consuming nature of the process when conventional (biochemical reaction-based) methods are used. […] Most infections with Actinomyces spp. are polymicrobial and members of the Streptococcus genus are the most commonly associated organisms. […] They act synergistically by inhibiting host defence mechanisms and reducing oxygen tension in the affected tissue, which enhances growth of Actinomyces spp. […] The pathogenesis of primary bladder actinomycosis is unclear, but could be due to cryptic locations, and usually mimics bladder carcinoma; the lesions may invade adjacent organs such as the uterus or the sigmoid colon.

• #87 The Korean Journal of Internal Medicine

  https://www.kjim.org/m/journal/view.php?number=8014

  Actinomycosis is an infectious disease caused by certain Actinomyces species. Actinomyces are Gram-positive, non-spore forming organisms characterized by obligate or facultative anaerobic rods that normally inhabit anaerobic niches of the human oral cavity. […] Actinomycosis is a chronic suppurative infection which infiltrates mucosa-associated tissues. […] A pivotal step in the pathogenesis of actinomycosis is disruption of the mucosal barrier. […] The hallmark of actinomycosis is the formation of the yellow sulfur granules. […] Actinomycosis has been called the most misdiagnosed disease and there is no disease which is so often missed by experienced clinicians. […] The radiographic findings are dependent on the chronicity of the disease. […] There are a few case reports of endobronchial actinomycosis. […] The treatment of choice for infection with Actinomyces is penicillin.

• #88 Actinomyces – Pathogenesis, Clinical Manifestation

  https://studymicrobio.com/actinomyces-pathogenesis-clinical-manifestation/

  Actinomyces spp. causes a chronic disease characterized by multiple abscesses and granulomata, tissue destruction, extensive fibrosis, and the formation of sinuses. […] Actinomyces spp. is normal floras of the oral cavity, low GI tract, and female genital tract. It causes the company of bacteria for infection or open to cause infection such as Bifidobacterium, Actinobacillus, Bacteroides, Eikenella, Haemophilus, Fusobacterium, Staphylococcus, Streptococcus, etc. These bacteria help in the initiation of infection by producing cytotoxins, and enzymes and by inhibiting host immunity. […] Once Actinomyces invade the tissue, they develop a chronic granulomatous infection characterized by the formation of tiny clumps known as sulfur granules because of their yellow color, size of granules 0.1-1mm in diameter, and composed of an internal tangle of mycelium filament, and a rosette of peripheral clubs. These granules are stabilized by a protein-polysaccharide complex which provides aid to host defense by inhibiting phagocytosis.

• #89 Actinomycosis: Microbiology, epidemiology, clinical manifestations, and diagnosis – UpToDate

  https://www.uptodate.com/contents/actinomycosis-microbiology-epidemiology-clinical-manifestations-and-diagnosis

  Actinomycosis is an infection characterized by abscess formation, induration, draining sinus tracts, fistulae, and tissue fibrosis. […] The microbiology, pathophysiology, epidemiology, clinical sites of infection, and diagnosis of actinomycosis will be reviewed here. […] A hallmark of actinomycosis is the tendency to spread without regard for anatomical barriers (including tissue planes or lymphatic drainage). This is often noted on imaging where a mass is seen aggressively crossing anatomic tissue planes. […] Actinomyces spp are noted for forming characteristic sulfur granules in infected tissue but not in vitro. The term „sulfur granule” is a misnomer, reflecting only the yellow color of the granule in pus, since they are not composed of any sulfur at all. The granules are actually discrete macroscopic grains of hard consistency, 100 to 1000 mcm in diameter, often visible to the naked eye or by microscopy with low magnification (10x). They are composed of an internal tangle of mycelial fragments and a radiating arrangement of eosinophilic peripheral clubs.

• #90 Actinomycosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/211587-overview

  Once infection is established, the host mounts an intense inflammatory response (ie, suppurative, granulomatous), and fibrosis may then follow. Infection typically spreads contiguously, frequently ignoring tissue planes and invading surrounding tissues or organs. Ultimately, the infection produces draining sinus tracts. Hematogenous dissemination to distant organs may occur in any stage of actinomycosis, whereas lymphatic dissemination is unusual.

• #91 ACTINOMYCOSIS | PDF

  https://www.slideshare.net/slideshow/actinomycosis-104339012/104339012

  Actinomyces species are classified as anaerobic, gram positive and filamentous bacteria. It is a chronic granulomatous suppurative and fibrosing disease caused by anaerobic or microaerophilic gram-positive nonacid fast, branched filamentous bacteria. The pathogenesis of actinomycosis is not entirely known. It is an endogenous infection and not communicable. It does not appear to be an opportunistic infection in a situation of depressed cell-mediated immunity. Trauma seems to play a role in some cases by initiating a portal of entry for the organisms, since they are not highly invasive. Thus the extracted socket, periodontal pocket, nonvital tooth, or mucosal abrasion may act as the portal of entry for the infection. […] The disruption of the mucosal barrier is the main step in the invasion of bacteria. Initial acute inflammation is followed by a chronic indolent phase. Lesions usually appear as single or multiple indurations. Central fluctuance with pus containing neutrophils and sulphur granules is diagnostic of the disease. The fibrous walls are typically described as woody. […] The diagnosis of actinomycosis depends not only upon clinical findings in the patient and the demonstration of the organisms in the tissue section or smear, but also upon their culture.

• #92 Actinomyces israelii – Wikipedia

  https://en.wikipedia.org/wiki/Actinomyces_israelii

  Actinomycosis is most frequently caused by A. israelii. Infection is established first by a breach of the mucosal barrier during various procedures (dental, gastrointestinal), aspiration, or pathologies such as diverticulitis. The chronic phase of this disease is also known as the „classic phase” because the acute, early phase is often missed by health care providers. This is characterized by slow, contiguous growth that ignores tissue planes and forms a sinus tract that can spontaneously heal and recur, leading to a densely fibrotic lesion. This lesion is often characterized as „wooden.” Sulfur granules form in a central purulence surrounded by neutrophils. This conglomeration of organisms is virtually diagnostic of A. israelii.

• #93 The Korean Journal of Internal Medicine

  https://www.kjim.org/m/journal/view.php?number=8014

  Actinomycosis is an infectious disease caused by certain Actinomyces species. Actinomyces are Gram-positive, non-spore forming organisms characterized by obligate or facultative anaerobic rods that normally inhabit anaerobic niches of the human oral cavity. […] Actinomycosis is a chronic suppurative infection which infiltrates mucosa-associated tissues. […] A pivotal step in the pathogenesis of actinomycosis is disruption of the mucosal barrier. […] The hallmark of actinomycosis is the formation of the yellow sulfur granules. […] Actinomycosis has been called the most misdiagnosed disease and there is no disease which is so often missed by experienced clinicians. […] The radiographic findings are dependent on the chronicity of the disease. […] There are a few case reports of endobronchial actinomycosis. […] The treatment of choice for infection with Actinomyces is penicillin.

• #94 Thoracic actinomycosis – EMCrit Project

  https://emcrit.org/ibcc/actinomycosis/

  Actinomycosis is a chronic infection with a tendency to dissect across tissue planes, in a fashion which often mimics cancer. It is frequently misdiagnosed initially. […] Infection is often promoted by violation of mucosal barriers, or superinfection of a foreign body or necrotic tissue. […] Aspiration is considered the primary mechanism promoting thoracic actinomycosis. Risk factors may thus include: Dental disease, poor dental hygiene. […] Actinomycosis will often mimic lung cancer or anaerobic pulmonary abscess. Thoracic actinomycosis is most frequently misdiagnosed as lung cancer. […] Actinomyces are branching, filamentous gram-positive rods. They may be anaerobic or facultatively anaerobic. […] Actinomyces species are anaerobic, which may hinder recovering and growing them. […] Diagnosis is generally made based on the microscopic identification of sulfur granules (masses of bacterial filaments). […] Sulfur granules suggest actinomycosis (yet they may occasionally be seen with Nocardia infection).

• #95 Actinomycosis: etiology, clinical features, diagnosis, treatment, and management – CIRI – Pathogenèse des légionelles

  https://univ-rennes.hal.science/CIRI-P-DOUBLET-S-JARRAUD-LEGIOPATH/hal-01908879v1

  Actinomycosis is a rare chronic disease caused by Actinomyces spp., anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and genital tracts. […] Bacterial cultures and pathology are the cornerstone of diagnosis, but particular conditions are required in order to get the correct diagnosis. Prolonged bacterial cultures in anaerobic conditions are necessary to identify the bacterium and typical microscopic findings include necrosis with yellowish sulfur granules and filamentous Gram-positive fungal-like pathogens. […] Patients with actinomycosis require prolonged (6- to 12-month) high doses (to facilitate the drug penetration in abscess and in infected tissues) of penicillin G or amoxicillin, but the duration of antimicrobial therapy could probably be shortened to 3 months in patients in whom optimal surgical resection of infected tissues has been performed.

• #96 Actinomycosis: Diagnosis, Clinical Features and Treatment | IntechOpen

  https://www.intechopen.com/chapters/82972

  The management of actinomycosis infection consists of prolong antimicrobial therapy, but surgical debridement and resection may be indicated in some cases. The use of antimicrobials has greatly improved the prognosis. Drug resistance is not considered a problem in actinomycosis and tends to be susceptible to beta-lactams antibiotics. For patients with monomicrobial infections, treatment can be divided base on mild versus severe disease. If the infection involves an organ causing a life threatening disease or multiple organs, it is considered severe. For mild actinomycosis, initial oral therapy with penicillin V (divided in four daily doses) is recommended. For severe infection, initial course of 10 to 20 million units daily of intravenous penicillin G (divided into four to six hours) is recommended. If the patient has penicillin allergy, a cephalosporin or doxycycline can be used.

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