Infection by Branching Filamentous Organisms

Question 1

Actinomyces (Actinomycosis)

Answer 1

• filamentous, anaerobic, Gram(+) commensual saprophytes present in oropharynx, GI tract, vagina–requires trauma to cause disease (anaerobic environment)
• Cervicofacial: jaw injury or after dental surgery–leads to purulent abscesses in jaw. “lumpy jaw” -form sulfur granules made of Splendore-Hoeppli material (tangled masses of branching filaments in polysaccharide protein matrix)
• Sinus tracts that penetrate lobe to lobe in pulmonary infections
• progressive, slow growing (anaerobic), disease that is well controlled by antibiotics
• Fatal if untreated

Question 2

Nocardia (Nocardiosis)

Answer 2

• respiration or cutaneous inoculation
• gram(+) aerobic filamentous
• May affect lungs, brain, skin or systemic dissemination in immunocompromised
• Disease of immunocompromised.
• Pyogenic: Pulmonary abcesses-pyogenic pneumonia w/ central necrosis.
• Fatal if untreated, long term antibiotics.