Micro - Actinomyces

Question 1

Characteristics of actinomyces infection

Answer 1

Abscess, fibrosis, localized swelling with suppuration, draining sinuses

Question 2

Actinomyces is: (G+, G-), (aerobe, anaerobe), (shape)

Answer 2

G+ anaerobe branching

Question 3

How to tell apart nocardia and actinomyces which are both G+ and branching?

Answer 3

Actinomyces is not acid-fast and is anaerobic, while nocardia is aerobic

Question 4

Common sites of actinomyces infection?

Answer 4

Cervio-facial, jaw, lung, GI

Question 5

Pathogenesis of actinomyces

Answer 5

Normal flora in mouth/GI –> trauma, surgery, infection, dental plagues, tonsillar crypts disrupt mucus membranes –> oxygen tension is low –> actinomyces (anaerobic) grows –> abscess

Question 6

Sx of pulmonary actinomyces

Answer 6

Pain with deep breath
Productive cough
Weight loss
Fever
Night sweats
Lethargy
SOB

Question 7

Key feature of actinomyces infection

Answer 7

Sulfur granules in pus

Question 8

Actinomyces is usually (acute, chronic) because:

Answer 8

Chronic, slow growing (may take months to diagnose)

Question 9

Demographics of people who get actinomyces infections

Answer 9

Men 30-60 yo

Question 10

How do you diagnose actinomyces infection?

Answer 10

Biopsy --> aspiration containing sulfur granules
Gram stain --> G+
Fluorescence stain
Histopathology of tissue
Slow growth on BAP

Question 11

(T/F): Actinomyces overwhelms other bacteria so will be only one in sample

Answer 11

False - often isolated with other bacteria

Question 12

Describe tx of actinomyces

Answer 12

Extensive due to slow-growing nature of actinomyces; IV PCN 4-6 weeks followed by PO PCN for several months; surgery is sometimes needed to drain fluid

Question 13

Alternative Abx to PCN for actinomyces tx

Answer 13

Clindamycin
Tetracyclines
Macrolides

Question 14

Buzz words for actinomyces

Answer 14

Sulfur granules
Sinus tract
Dental procedures
Painless abscess