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ACTINOMYCETESDepartment Of Microbiology, ITS CDSR

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INTRODUCTION Domain: Bacteria Phylum: Actinobacteria Class: Actinobacteria

Order: Actinomycetales Family: Actinomycetaceae Genus:Actinomyces

Gram positive, filamentous bacteria intermediate in

properties between true bacteria and fungi Form mycelial network of branching filaments like fungi

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FamilyActinomycetes contains three medically importantgenera:

1. Actinomyces : (CausesActinomycosis)A. bovis A. bowdenii A. canis A. Cardiffensis A. Catuli A.

coleocanis A. dentalisA. denticolens A. europaeus A. funkei A. georgiae A. gerencseriae A.graevenitzii A. hongkongensis A. hordeovulneris A.howellii A. humiferus A. hyovaginalis A. israeliiA.marimammalium A. meyeri A. naeslundiiA. nasicola A.neuii A. odontolyticus A. oricola A. radicidentis A.radingae A. slackii A. streptomycini A. suimastitidis A. suisA. turicensis A. urogenitalis A. vaccimaxillae A. viscosus

1. Nocardia: (Causes Nocardiosis)

2. Actinomadura: (Causes Red grain mycetoma of the4/22/12 Department Of 33

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MORPHOLOGY

Non motile Non sporing

In tissue, Appear in pus as granules Clubs- Gram negative, acid fast, host origin. Filaments- Gram positive, non acid fast

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Fig

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Fig

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Fig 1. Actinomyces Fig 2. Actinomyces (Electronmicroscopic view)

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CULTURE Grows best under anaerobic or microaerophilic

conditions.

Optimum temp 37 degrees celsius under 5-10% CO2.

Culture media: Brain heart infusion agar

: Blood agar

: Thioglycollate broth

Growth seen after 2-3 days, except,A.israelii: 7-14 days. Solid media: Spidery colonies formed get heaped up. Liquid media: Small fluffy balls below the surface of

medium. Sun ray appearance

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PATHOGENESIS Causes disease known asActinomycosis.

Occurs rarely in humans but rather frequently in cattle as adisease called lumpy jaw. This name refers to the largeabcesses that grow on the head and neck of the infectedanimal.

It can also affect swine, horses, and dogs, and less oftenwild animals and sheep.

A chronic granulomatous disease characterised bymultiple abscesses, tissue destruction, fibrosis andformation of multiple sinuses.

Causative specie in man:A. israelli

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It has four clinical forms:

1. Cervicofacial: Commonest, occurs in cheek and submaxillaryregions.

2. Thoracic: Lungs

3. Abdominal: Ileocaecal region

4. Pelvic: Associated with use of intrauterine devices

. Macroscopically, painless indurated swelling with multipledischarging sinuses

. Pus contains yellow colored sulphur granules. May also present as mycetoma

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ACTINOMYCES AND NOCARDIAACTINOMYCES NOCARDIA

1. Anaerobic and Non acid fast2. Causative specie:A.israeli (humans)3.

Recovery is possible4. Natural habitat of is mouth, intestineand vagina

5. A. bovis extremely sensitive topenicillin

6. Early stages may be treated withbroad spectrum antibiotics

7. Clinical forms: Abdominal, Thoracic,Pelvic, Cervico facial8. Endogenous infection9. Culture: Solid media- Spidery

colonies

1. Aerobic and Acid fast2. Causative specie: N.Asteroides

(humans)3. Usually fatal4. Natural habitat is soil

1. N. Asteroides resistant to anytreatment

2. Targeted approach required,

Sulfadiazine MUST be included indrug regimen3. Clinical forms: Cutaneous infection,

Systemic nocardiasis4. Exogenous infection5. Culture: Solid media- Dry wrinkled

colonies

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LESIONS OF ACTINOMYCOSIS AND NOCARDIOSIS

4/22/12 Department Of 1414Actinomycosis Nocardiosi

s

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DENTAL ASPECTS A. naeslundii, A. meyeri, A. odontolyticum are associated

with formations ofdental plaque

Can also cause gingivitis and periodontitis

A. israelii may occur as commensals in mouth of normalindividuals mainly around the teeth

Infection is mostly endogenous and may result from

trauma. Eg: Dental extraction

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EPIDEMIOLOGY Non contagious disease

Mostly endogenous infection

Frequently seen in rural areas

70% are cervicofacial and 20% abdominal.

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LABORATORY DIAGNOSIS1. SPECIMENS

. Pus from lesion or sinuses

. Discharge from fistula

. Sputum in pulmonary disease

. Tissue or biopsy

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2. MICROSCOPY

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Gram stain shows dense network ofthin Gram positivefilaments, surrounded by a peripheral radiating Gramnegative clubs

Acid fast staining shows central part as non acid fastsurrounded by acid fast clubs.

In tissue sections, sulphur granules and mycelia aredetected by using fluorescein-conjugated specificantisera

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3. BIOPSY

Haematoxylin-eosin stained section shows mycelial masssurrounded by pus cells and chronic inflammatorycells.

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TREATMENT

Surgical removal of affected tissue along with penicillin or

tetracycline therapy is effective

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