What is actinomycosis?

Actinomycosis is characterized as a chronic infection triggered by Actinomyces israelii. This is an anaerobic bacterium that normally thrives on the enamel of teeth, tonsils, gums and membranes that lines the intestines and the vagina.

The bacteria can trigger infection only if the tissue surface where they exist on is damaged, thus allowing them to gain entry to the deeper tissues that do not have any defenses against them. As the infection widens, scar tissue along with irregular channels develop. After a span of months to years, fistulas might eventually reach the skin and enable the drainage of pus. In addition, pockets of pus might develop in the abdomen, chest, neck or face.

What are the indications of actinomycosis?

It is important to note that actinomycosis has various forms that all cause the development of abscesses.

Abdominal

The bacteria infect the intestine usually the region close the appendix and the lining of the abdominal cavity and causes the following symptoms:

  • Fever
  • Chronic abdominal pain
  • Vomiting
  • Diarrhea
  • Constipation
  • Severe weight loss
    Actinomycosis

    Chronic abdominal pain is one of the symptoms of actinomycosis.

Fistulas might form from the interior of the abdomen up to the skin above it as well as between the intestine and other organs.

Pelvic

The bacteria can spread to the uterus, usually from an IUD that has been in place for many years. Abscesses and scar tissue might form in the ovaries, fallopian tubes and adjacent organs such as the ureters and bladder. Take note that fistulas can form between these organs.

The symptoms include the following:

  • Pelvic or abdominal pain
  • Weight loss
  • Fever
  • Vaginal bleeding and discharge

Thoracic

  • Chest pain
  • Fever
  • Weight loss
  • Coughing with sputum

The abscesses might form in the lungs and later on spread to the membrane between the lungs and the chest wall. The presence of fistulas will allow the infection to spread to the ribs, spine and skin of the chest.

Cervicofacial

  • Small, hardened swellings in the mouth and on the neck, face or skin below the jaw.
  • Drainage of pus that contain small, round yellowish granules.

Generalized

In rare circumstances, the bacteria are transported in the bloodstream to infect other organs such as the spine, brain, liver, lungs, kidneys and the heart valves. Among women, the reproductive organs might be infected.

The symptoms tend to vary depending on the organs that are affected. Some individuals might experience a headache, abdominal pain or even back pain.

Management

Antibiotics such as penicillin or tetracycline should be taken for at least 2 months and might be used for more than 12 months.

MRI or CT scan might be used to check if the abscesses are resolving. Surgery might be required especially if the infection affects vital areas such as the spine.

If actinomycosis is diagnosed early and treated properly, most individuals are able to fully recover. The recovery is linked to the body parts that are affected. Recovery is ideal when only the neck and the face are affected and worse if the infection is generalized particularly if it affects the brain.

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