Actinomycosis

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Actinomycosis is an infectious disease that occurs as a result of the introduction into the body of actinomycetes.

Actinomycosis can affect all organs and tissues, but more often there is actinomycosis of the maxillofacial region and neck. Mostly sick men, mostly urban residents.

The disease develops with the penetration of actinomycetes into the tissue, which is accompanied by the formation of specific granulomas. In the maxillofacial region, the source of infection is carious teeth, pathological gingival pockets for periodontal diseases, difficult eruptions of teeth, mucous membranes of the oral cavity with its trauma, amygdala, ducts of the salivary glands, etc. Actinomycosis occurs with a decrease in nonspecific protective reactions of the body and immunity, more often On a background of purulent-inflammatory processes and traumas. Actinomycetes can spread in the body by contact, lymphogenous and hematogenous pathways and often settle mainly in loose connective tissue.

Clinical picture . The general condition of the patient in the initial stages of the disease varies little. Body temperature is subfebrile. With long-term current forms of actinomycosis, body temperature may not rise. With actinomycosis of the maxillofacial region, a dense weakly painful infiltrate develops, which slowly softens. The skin is usually soldered with an infiltrate, hyperemic. The focus (or foci) is abscessed with the formation of fistulas, after which the infiltrate is limited, but does not completely resolve. Often observed inflammatory contracture of the masticatory muscles. The disease occurs with exacerbations, which often lead to the spread of the process with the formation of new foci of actinomycosis.

With thoracic actinomycosis, the lungs, chest wall, mediastinum are affected; At abdominal - more often ileocecal angle of an intestine, anterior abdominal wall.

In addition to the local process, metastatic damage to the brain, lungs, the development of amyloidosis of internal organs is possible.

The diagnosis is established on the basis of clinical data and the results of the study of the actinomycetes isolated from the focus (detection of actinomycetes in it), a diagnostic skin-allergic reaction with actinolysate, other methods of immunodiagnostics, radiologic, and in some cases pathomorphological studies. In addition, a cytological study of stained smears for the presence of mycelium of actinomycetes, and sometimes the isolation of pathogenic culture by sowing.

Treatment is complex. It includes surgical methods, methods of increasing immunity by using actinolysate or other immunostimulants (thymilin, T-activin), stimulating and restorative therapy, amphotericin B, antibiotics, sulfonamides, antiseptic and desensitizing drugs, physiotherapy procedures. The scope and nature of surgical intervention depends on the form of the disease and the localization of its foci.

The prognosis for life with actinomycosis of the maxillofacial region is usually favorable, with actinomycosis of other localizations it can be serious.

Prevention consists in the sanation of the oral cavity, removal of foci of purulent infection, increasing the body's resistance.