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Fungus like Bacteria

Fungus like Bacteria. Actinomadura madurae. Actinomyces. Mycetoma Madura foot. Nocardia brasiliensis. Streptomyces somaliensis. Mycobacterium. Tropheryma whippelii. Actinomyces. (Ray like appearance in granules- ray fungus). Actinomycosis. Chronic granulomatous infection.

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Fungus like Bacteria

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  1. Fungus like Bacteria Actinomadura madurae Actinomyces Mycetoma Madura foot Nocardia brasiliensis Streptomyces somaliensis Mycobacterium Tropheryma whippelii

  2. Actinomyces (Ray like appearance in granules- ray fungus) Actinomycosis Chronic granulomatous infection Indurated swellings, sinus tract, discharge of sulphur granules (3S) Commensals in mouth, intestine & vagina (endogenous infection) Trauma, foreign body or poor oral hygiene - tissue invasion A. israelii (common) A. naeslundi, A. viscosus, A. odontolyticum, A. meyeri

  3. Clinical Forms Cervicofacial: cheek & submaxillary regions Thoracic: lung, pleura & pericardium, chest wall Abdominal: ceacum, with neighboring tissues & abdominal wall Pelvic. Many cases in association with IUDs

  4. Lab diagnosis Specimens: pus, sputum, Cx swab Demonstration of granules (saline suspension & microscopy) Gram stain Gram positive filaments, surrounded by a peripheral zone of swollen radiating club shaped structures, presenting a sun ray appearance. Culture Thioglycolate broth: fluffy ball BHI agar: spidery colony Identification Gel diffusion, Immunofluorescense

  5. Gram stain : Actinomycetes BHI agar: spidery colony

  6. Nocardia (Aerobic actinomycetes) Gram positive bacteria Branching filaments tend to fragment into rods & cocci Partially acid fast (AFB) - 1% sulphuric acid Culture Ordinary media Dry, granular, wrinkled, pigmented

  7. Nocardia O P P O R T U N I S T I C Source: mud, compost, rotting vegetables Inhalation - air borne Inoculation into wound N asteroides N brasiliensis Primary pneumonitis Madura foot Ectopic foci via blood Lympho-cutaneous disease Any organ Brain abscesses Kidney infections

  8. Lab diagnosis Sample Exudate (contains colored sulphur granules) Microscopy Grams / AFB stain Culture Pigmented (bread crumb appearance) Treatment Co-trimoxazole / ceftriaxone / amikacin

  9. Comparison Features Nocardia Actinomyces Gram stain Gm + branching filament Gm + filament with sun ray appearance Acid fast stain acid fast non acid fast anaerobic Culture aerobic Infection exogenous endogenous penicillin / tetra Treatment co-trimoxazole

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