Gram (+) Branching Filamentous Rods Flashcards
List the gram(+) branching filamentous rods
Actinomyces Israeli
Nocardia
What does actinomyces israeli look like?
Branching rod
Actinomyces israeli respiration
Obligate anaerobe
Where is actinomyces normally found?
Normal flora of the oral cavity.
What situation is actinomyces infection most associated with?
Recent jaw trauma
It takes advantage of tissue injury, allowing it to spread along head and neck.
Question may feature someone who had “recent dental work”
Actinomyces infection course
Infection sets in and invades surrounding tissues. It causes cervicofacial actinomyces infection.
Slow course starting with nontender lump on jaw.
Forms abscess and later sinus tracks that drain infection through skin. The drainage is a thick, yellow pus.
It is yellow bc of sulfur granules.
Actinomyces Tx
Penicillin G
More complex cases may need surgical drainage
What does nocardia look like?
Branching rods
Weakly stains acid-fast due to mycolic acids in its cell wall.
Where is Nocardia usually found?
Soil, but it is NOT spore forming
Who is most at risk for Nocardia infection?
Immunocompromised - Pts with HIV, transplant pts, pts taking glucocorticoids, old people
Men > women
Nocardia infection symptoms
Infects 3 sites: Pulmonary, CNS, cutaneous
Pulm: Pulmonary nocardiosis leads to pneumonia with lung abscess formation and cavitary lesions
CNS: Nocardia has affinity for neural tissue so pulmonary nocardiosis can lead to formation of brain abscesses
Cutaneous: Pyogenic response with production of indurated lesions. Inflammatory
Gardening, construction work, carpentry, car accidents - anything that can lead to skin opening in presence of dirt.
Tx for Nocardia
Sulfonamides
