Peter Julius Ngala, DDS

Actinomycosis is caused by Actinomyces.

Which are considered to be a transitional forms between bacteria and fungi.

Actinomyces Israeli is the most common Actinomyces causing human infection.

In humans, Actinomyces species usually cause diseases like

Cervicofacial actinomycosis

Thoracic actinomycosis

Actinomyces species are present as normal flora of the oral cavity and also in the lower gastrointestinal tract and female genital tract of human hosts.

Establishment of human infection by Actinomyces always requires the presence of a companion bacteria.

These companion bacteria help in initiation of infection by producing a toxin or enzyme or by inhibiting host immunity.

Finally the infection results in the production of draining sinus tracts, which contain a lot of damaged tissue.

Actinomycosis is a subacute and chronic bacterial infection characterized by suppurative and granulomatous inflammation.

The condition is associated with the formation of multiple abscesses and the development of sinus tracts discharging white to yellowish granules, known as Sulphur granules.

It is the most common manifestation in humans comprising about two-thirds of all reported cases.

The infection occurs in the cervicofacial region, which typically occurs following oral surgical procedures in patients with poor oral hygiene.

Initially the condition manifests as a swelling of the soft tissue of the peri mandibular area.

During the course of the infection, the disease spreads and leads to the formation of fistulas.

These fistulas or sinus tracts discharge purulent material containing yellow granules, known as Sulphur granules.

Laboratory diagnosis is made by direct detection of Actinomyces in specimens by microscopy and by isolation of organism by culture.

Microscopy diagnosis to detect the Sulphur granules

High dose Penicillin or tetracycline given over a prolonged period.

Surgical therapy is included for more extensive and complicated cases.