Expired CME Article

Actinomycosis: Diagnosis and Management

Authors: Itzhak Brook, MD, MSc

Abstract

Actinomycosis is an uncommon, chronic bacterial infection that induces both suppurative and granulomatous inflammation. Localized swelling with suppuration, abscess formation, tissue fibrosis, and sinus drainage characterizes this disease. The infection spreads contiguously, often forming draining sinuses that extrude characteristic but not pathognomonic “sulfur granules.” Infections of the oral and cervicofacial regions are most common; however, any site in the body can be infected and it often mimics malignancy. Other regions that are often affected are the thoracic and abdominopelvic, as well as the central nervous system. Musculoskeletal and disseminated disease can also be seen, albeit rarely. Prolonged antimicrobial therapy with penicillin has typically been recommended for patients with all clinical forms of actinomycosis to prevent disease recrudescence.


Key Points


* Actinomycosis spreads contiguously, forming draining sinuses that extrude characteristic “sulfur granules.”


* It can cause localized swelling with suppuration, abscesses, tissue fibrosis, draining sinuses, and often mimics malignancy.


* The regions commonly affected are the oral and cervicofacial, thoracic, and abdominopelvic, as well as the central nervous system.


* Proper drainage is needed if abscesses are present, and prolonged therapy with penicillin is the treatment of choice.

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