Actinomyces & Nocardia

7/29/2019 Actinomyces & Nocardia

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Actinomyces


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Actinomyces israelii


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Gram positive filamentous bacilli

Obligate anaerobe

Actinomyces actually means "ray fungus" in Greek

Previously thought as fungi, but they Bacteria

Sulfur granules

Important species A.Israellii


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Sulphur granules

sulphur granule is shown in the

Courtesy by Dr.Alvin fox


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Epidemiology

Endogenous

Gums, GIT and female ganital tract

Opportunistic,following disruption of mucosal barriers by tr

surgery or infection

No person to person transmission


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Clinical features

Suppurative and granulomatous

multiple abscesses and interconnecting sinus tracts

Micro coloniessulfur granules

bone involvement

Common areas of lesions Cervicofacial

Thoracic

Abdominal

Pelvic

Cranial


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Actinomyces infection


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Diagnosis

Slow growth (up to two weeks or more)

Colonies have "molar tooth" appearance on agar

Sulfur granules

Treatment

Penicillin

Surgery and debridement


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Nocardia


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Nocardia

Gram positive- weakAcid Fast- weak

Filamentous branching

Strict aerobe

Blood Agar- 1-4 days produce colonies (slow growth

Rough, irregular, chalky appearance colonies

2 impt organisms:

Nocardia Asteroids- Pulmonary Nocardiosis

Nocardia Brazilicnes- Cutaneous Nocardiosis


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Nocardia


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Epidemiology

Present in soil, intestines of humans & animals

Inhalation- Pulmonary Nocardiosis

Thorn Picks- Cutaneous Nocardiosis

No case to case transfer

No virulent factors known

No pathogenesis known


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Clinical Features

Pulmonary Nocardiosis

Acute/chronic/relapsing-bronchopneumonia

Cavities in lungs

In brain circulation- brain abscess

Cutaneous Nocardiosis

Cellulitis

Sinus tract-mycetoma- progressive chronic granulmatouinfection


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Diagnosis

Clinically

Gram stain- filamentous

Acid Fast- take the stainingBlood Agar Culture- aerobic conditions

Pigment: white-orange

Treatment

Sulfanamides

Documents

Actinomyces & Nocardia