Actinomycetales infection

Overview

Actinomycosis is a chronic bacterial infection that commonly affects the face and neck. It is usually caused by an anaerobic bacteria called Actinomyces israelii. This order contains several different groups of bacteria that are shaped like thin filaments or rods, including the Mycobacteria that are best known as the cause of tuberculosis. Bacteria from all of these groups cause a wide variety of diseases.

It is an infectious disease that can occur throughout the body. Actinomycosis is most commonly due to the species Actinomyces israelii, which causes infections that typically affect the face and neck but can involve other areas of the body as well.These bacteria normally reside in the nose, mouth and throat, where they do not cause problems. Actinomyces are normal inhabitants of the mouth, gastrointestinal tract, and female genital tract, and do not cause an infection unless there is a break in the skin or mucosa. The infection usually occurs in the face and neck, but can sometimes occur in the chest, abdomen, pelvis, or other areas of the body. The infection is not contagious. Disease may occur if they enter the skin or body as a result of injury or surgery, through a tooth abscess, by aspiration, if another infection is present, or if an intrauterine device (IUD) is present.

Symptoms

  • Lung inflammation
  • Loss of appetite
  • Cough
  • Chest pain
  • Coughing up blood
  • Weight loss
  • Weakness
  • Headache
  • Lethargy
  • Confusion
  • Organ abscesses
  • Skin abscess
  • Fever
  • Night sweats
  • Enlarged liver
  • Enlarged spleen

Causes

A. israelii occurs as part of the normal flora of the throat, tonsillar crypts, and mouth (particularly around carious teeth); infection results from its traumatic introduction into body tissues. Actinomycosis affects twice as many males — especially those ages 15 to 35 — as females. People with dental disease or human immunodeficiency virus infection are at increased risk.

Treatment

Treatment is long term, with 1 to 2 months of penicillin I.V. followed by 6 to 12 months of penicillin taken by mouth. Doxycycline usually isn’t prescribed for children until after permanent teeth have erupted. In some cases, surgical drainage of the lesion may be required.