Actinomycosis

Actinomycosis is a radiation -fungal disease caused by various kinds of actinomycetes saprophytic in the oral cavity. The causative agent is more often actinomycetes of Wolff-Israel. The fungus becomes pathogenic in the oral cavity, if it is introduced into the mucosa with infected wounds and pockets, especially in combination with other microbes. A similar situation can arise when chewing cereal ears.

Symptoms, course. Characteristic is the formation of a woody density of bright red infiltrates with a cyanotic shade in the thickness of the skin without an increase in regional lymph nodes. Then there is a recurrence of infiltrates and a breakthrough of pus with the formation of fistulas, the purulent discharge of which usually has a greenish tint with impregnations of yellowish granules. At a microscopic examination, find out druses of radiant fungi. The spread of the process occurs intracutaneously along the tissue gaps, and not along the lympho- and blood vessels. Clinical variants: cervico-fascial form (localization on the neck), lesion of the thoracic wall (spread from the lung) and abdominal shape (more often in the right iliac region, in anamnesis appendectomy with the formation of fistula of the cecum in the postoperative period).

Complications, with cervico-fascial form - meningitis, mediastinitis. With a thoracic form, it is possible to form basal infiltrates with subsequent involvement of the lung in the process of the root, as well as damage to the ribs. In the abdominal form, actinomycetes can enter the liver through the portal system and lead to the development of its abscesses.

Treatment. Antibiotics penicillin series after determining the sensitivity for 2-3 weeks. Simultaneous dissection or excision of available infiltrates and abscesses.

The prognosis for cervico-fascial form before the development of complications is favorable.