Actinomycosis – Definition – Causes – Symptoms

Definition of Actinomycosis
Actinomycosis is an infection primarily caused by the bacterium Actinomyces israelii. Infection most often occurs in the face and neck region and is characterized by the presence of a slowly enlarging, hard, red lump.

Description of Actinomycosis
Actinomycosis is a relatively rare infection occurring in one out of 300,000(1/300,000) people per year. It is characterized by the presence of a lump or mass that often forms, draining sinus tracts to the skin surface. Fifty percent of actinomycosis cases are of the head and neck region (also called ‘‘lumpy jaw’’ and ‘‘cervicofacial actinomycosis’’), 15% are in the chest, 20% are in the abdomen, and the rest are in the pelvis, heart, and brain. Men are three times more likely to develop actinomycosis than women.

Causes of Actinomycosis
Actinomycosis is usually caused by an anaerobic bacteria called Actinomyces israelii, which is a common and normally not disease-causing (nonpathogenic) organism found in the nose and throat.
Because of the bacteria's normal location in the nose and throat, actinomycosis most commonly appears in the face and neck. The infection is not contagious.

Symptoms occur when the bacteria enters the facial tissues after trauma, surgery, or infection. A common cause is dental abscess or oral surgery. Once in the tissue, it forms 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. Actinomycosis can sometimes occur in the chest (pulmonary actinomycosis) and abdomen or other areas of the body.

Symptoms of Actinomycosis
    * Draining sores in the skin, especially on the chest wall from lung infection with Actinomyces
    * Fever
    * Minimal or no pain
    * Swelling or a hard, red to reddish-purple lump on the face or upper neck
    * Weight loss

Diagnosis of Actinomycosis
Actinomycosis may be hard to diagnose at onset. There are lab tests that may isolate actinomyces in pus or tissue specimens.

Treatment of Actinomycosis
Treatment for actinomycosis is long term, generally with up to one month of intravenous penicillin G, followed by weeks to months of penicillin taken by mouth. Additionally, surgical excision and drainage of abscesses may be necessary.

Complications of Actinomycosis
Abscesses from actinomycosis may occur in many parts of the body, including the lungs, and can spread easily from one part of the body to another.
If the original site of infection is in the skin of the face, it may spread to nearby parts of the body such as the scalp or ears. If the original site of the infection is the mouth, it may spread to the tongue, larynx (vocal chords), trachea (windpipe), salivary glands, and the tubes that connect the throat to the nose.

Unlike other bacterial infections, actinomycosis will move easily from one layer of tissue to the next. Instead of simply travelling across the surface of the skin, for example, it can move down to deeper parts of the body. Unlike most infections, it can also move to other parts of the body without travelling through the lymphatic system, the body's network of glands.

If the infection spreads to the meninges (the membranes that cover the brain and spinal cord) meningitis can develop.

WHAT TO DO
Actinomycosis carried a high percentage of fatality before antibiotics became available. In the more serious cases, surgery must be combined with the use of penicillin or other antibiotic drug. Of course, all cases must be under the physician's care.

Resources

http://www.nlm.nih.gov/medlineplus
http://www.healthscout.com/

http://www.cks.nhs.uk/