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Actinomycetes: Bacteria Resembling Fungi in Disease

Actinomycetes are thin bacteria with a muramic acid cell wall, resembling fungi superficially. They cause actinomycosis, a chronic granulomatous disease, and are associated with various clinical forms. Actinomyces, Nocardia, and other genera are involved. This disease is more common in rural areas and agricultural workers, affecting mainly young males. Diagnosis involves laboratory testing methods such as specimen examination and culture isolation. Treatment includes medical therapy with antibiotics and surgical options for drainage or excision.

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Actinomycetes: Bacteria Resembling Fungi in Disease

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  1. ACTINOMYCETES

  2. Thin bacteria with muramic acid cell wall. • Superficial resemblance to fungii due to branching filaments. • Related to Corynebacteria and mycobacteria resemble fungi • Gram positve, non motile, non sporing, non capsulated filamentous bacteria. • Include foll genera - Actinomyces, Arachnia, Bifidobacterium - Nocardia, Actrinomadura, Streptomyces

  3. ACTINOMYCES • Cause actinomycosis - a chronic granulomatous disease • C/ by indurated swelling, suppuration and discharging of sulfur granules from sinuses. • Infection usually endogenous. • A.israelli is the MC cause. • May be accompanied byother bacteria which increase the pathogenicity

  4. 4 clinical forms; 1. cervicofacial 2. Thoracic 3. Abdominal 4. Pelvic • Also associated with inflammatory disease of gums. • Can also present as mycetoma • The disease is characterised by presence of Sulfur granules in the exudate

  5. Worldwide in distribution • More common in rural areas and agricultural workers • Young males 10-30 yrs age group more common. • Pelvic infection seen in women using intrauterine devices. • Organism occurs as commensal in mouth, URT and female genital tract. • Have low virulence

  6. Laboratory diagnosis • Specimen- pus, sputum, biopsy • Gross examination of granules • Microscopy • Isolation in culture- media used BHIA and Thioglycollate broth. • A. israelli- small spidery colonies which become heaped up, white irregular or smooth and large in 10 days • Species identification

  7. Sulfur granules are white to yellow with siz ranging from minute specks to about 5mm and are found only in tissue.

  8. TREATMENT • MEDICAL TREATMENT- prolonged treatment with penicillin or tetracycline • SURGICAL TREATMENT- drainage or excision

  9. NOCARDIA • PRESENT IN SOIL • Infection exogenous • Species associated N.asteroides, N. Brasiliensis and N. caviae • May be cutaneous, subcutaneous or systemic lesions in humans • Pulmonary form is MC • Occurs by inhalation of bacilli • Common cause of pneumonia in immunocompromised hosts

  10. LABORATORY DIAGNOSIS • Specimen • Macroscopic examination of pus • Microscopy by Gram and ZN stain • Isolation done on routine media. • Colonies are dry to chalky, yellowish.

  11. TREATMENT • MEDICAL Rx- sulfa drugs like TMP-SMX • SURGICAL Rx- drainage of abscess

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