What Is Actinomycosis? What Causes Actinomycosis?

Date: May-08-2012Actinomycosis is a rare type of infectious bacterial disease. Unlike other infections, actinomycosis is able to move gradually and infiltrate the body's tissue, causing swelling and inflammation. Eventually there is tissue damage and scaring, pus-filled abscesses appear in the mouth, lungs, or gastrointestinal tract. Small holes leaking pus form in the affected tissue.

Actinomycosis is caused by a species of bacteria known as actinomyces, which live harmlessly in the lining of the mouth, throat, digestive system and women´s vagina. If the tissue-lining becomes damaged by injury or disease, the bacteria can penetrate deeper into the body - the actinomyces bacteria then thrive deep inside human tissue.

This bacterial disease is very rare in humans, but more common in farm animals. In cattle it is called lumpy jaw

According to Medilexicon's medical dictionary: actinomycosis is:

"A disease primarily of cattle and humans caused by the bacterium Actinomyces bovis in cattle and by A. israelii and Arachnia propionica in humans. These actinomycetes are part of the normal bacterial flora of the mouth and pharynx, but when introduced into tissue they may produce chronic destructive abscesses or granulomas that eventually discharge a viscid pus containing minute yellowish granules (sulfur granules).

In humans, the disease commonly affects the cervicofacial area, abdomen, or thorax; in cattle, the lesion is commonly found in the mandible."
What are the different types of actinomycosis?
Oral cervicofacial actinomycosis: The infection develops inside the tissue of the neck, jaw or mouth. Most cases are a complication of dental problems, poor oral hygiene, gum disease, dental abscess, tonsillitis, dental or jaw surgery. This is the most common type of actinomycosis and accounts for an estimated half of all cases.

Thoracic actinomycosis: The infection develops inside the lungs or connected airways. Most cases of thoracic actinomycosis are caused by people accidentally ingesting contaminated material into their lungs.

Abdominal actinomycosis: The infection develops inside the stomach. It can occur when something tears the wall of the intestine, allowing the bacterium to penetrate into deep tissue. This can happen after accidentally swallowing an object (a fish or chicken bone) containing actinomyces bacteria. Also, it can develop as a complication following removal of the appendix or bowel or abdominal surgery.

Pelvic actinomycosis: The infection develops inside the pelvis. The actinomyces bacteria spread from the female genitals into the pelvis. This type of infection is associated with the long-term use of the intrauterine device (IUD) type of contraceptive. Although very unlikely, the IUD may damage the womb lining over time, allowing bacteria to penetrate into deep tissue.

Actinomycosis of Maxilla. The disease spread to opposite side; finally implicated base of skull, and proved fatal. Treated by radium. (Mr. D. P. D. Wilkie's case.)

What are the signs and symptoms of actinomycosis?
A sign is something everyone can see, such as a rash or swelling, while a symptom is something only the patient experiences and describes to a doctor, nurse, family member or friend, such as a headache, dizziness or anxiety.

Abscesses grow larger as the disease progresses. In severe cases, narrow passages called sinus tracts can form on the surface of the skin. They may break open and leak large amounts of pus. The signs and symptoms vary according to the affected area.

The signs and symptoms of oral cervicofacial actinomycosis may include:
Fever of 38°C (100.4°F).

Swollen lumps on cheek or neck. They gradually increase in size and number. Lumps are tender and later become painless and hard.

Reddish or bluish colored skin over the lumps.

Jaw muscles may also be affected, making chewing difficult.

Narrow passages (called sinus tracts) can form on the surface of the skin leaking pus.

The signs and symptoms of thoracic actinomycosis may include:
Fever of 38°C (100.4°F).

Weight loss.

Fatigue.

Poor appetite.

Shortness of breath.

Chest pain.

Dry cough, or a cough that produces phlegm.

Drops of blood when coughing or blood-stained phlegm.

Sinus tracts forming on the surface of the chest.

The signs and symptoms of abdominal actinomycosis may include:
Mild fever, no higher than 38°C (100.4°F).

Weight loss.

Fatigue.

Constipation or diarrhea.

Stomach pain.

Nausea.

Vomiting.

Noticeable bulge or lump in the lower abdomen.

Appearance of sinus tracts on the surface of the abdomen.

The signs and symptoms of pelvic actinomycosis may include:
Mild fever.

Lower abdominal pain.

Abnormal vaginal bleeding.

Unusual vaginal discharge.

Loss of appetite.

Fatigue.

Noticeable bulge or lump in the pelvis.

How is actinomycosis diagnosed?
In the earlier stage, this bacterial infection is difficult to diagnose because it can be can be confused with other conditions. Often, a correct diagnosis is made after taking and examining a sample (biopsy).

It is more easily diagnosed in its later stages, after its hallmark sinus tracts have appeared in the surface of the skin.
What are the treatment options for actinomycosis?
The patient will be put on a long-term course of antibiotics - this is the only way to eliminate the infection completely.

Antibiotic injections are initially recommended, followed by a course of antibiotic tablets.

Penicillin is very effective in treating some types of bacterial infections. In cases of penicillin allergy, alternative antibiotics can be used.

Some patients may take several months before they respond properly to treatment.

In severe cases, surgery may be required to repair tissue damage or to drain the pus from abscesses that have formed deep inside the body.

Abscesses can spread easily from one part of the body to another. Complications may occur when the disease extends from the original site of the infection to other organs.
Dental hygiene
Oral actinomycosis, the most common form, usually occurs because of poor dental hygiene. Prevention can be achieved by practicing good dental hygiene, i.e. brushing teeth twice a day, flossing and using a mouthwash that contains fluoride once a day, attending regular dental check-ups, and limiting sweet food.

Written by Christian Nordqvist

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