ACTINOMYCETALES By   Dr. P.S.Reddy MD For e-learning
Fungus – like bacteria.  This family includes :  Actinomyces,  Bifidobacterium  Rothia,  Arachnia. Nocardia,  Actinomadura...
<ul><li>Transitional forms  between bacteria & fungi.  </li></ul><ul><li>Cell walls with muramic acid.  </li></ul><ul><li>...
<ul><li>Actinomyces:   </li></ul><ul><ul><ul><li>Ray – like  appearance. </li></ul></ul></ul><ul><ul><ul><li>Soil saprophy...
IN THE HOST  Sulphur granules   in the pus. Granules: Small specks to 5mm.  White / Yellowish.  Gram staining.  Central  f...
CULTURE   Liquid medium:   As “fluffy balls” RCM.  Thioglycollate broth 1% glucose broth.   Solid medium  : Blood Agar.  B...
<ul><ul><ul><li>Species causing Actinomycosis </li></ul></ul></ul><ul><ul><ul><li>A. israelii,  </li></ul></ul></ul><ul><u...
PREDISPOSING FACTORS     Periodontal disease,    Trauma, Poor oral hygiene    Jaw fractures,    Maxillo facial surgeries, ...
<ul><li>Actinomycosis </li></ul><ul><li>Chronic  granulomatous Lesion  </li></ul><ul><li>with multiple abscesses, fibrosis...
<ul><li>CERVICOFACIAL  ACTINOMYCOSIS   </li></ul><ul><li>Odontogenic in origin. </li></ul><ul><li>Appears as red lump with...
Gingival actinomycosis Mycetoma of foot
Thoracic  actinomycosis:   Sinuses on chest wall,   Eroded ribs and spine.  Abdominal actinomycosis: Ileocaecal region.  A...
X-ray  findings of Thoracic Actinomycosis
<ul><ul><ul><li>Pelvic  actinomycosis : I U C D. </li></ul></ul></ul><ul><ul><ul><li>Punch actinomycosis : </li></ul></ul>...
Laboratory  diagnosis:  1.  Pus 2.  Sputum (not reliable)  Specimen + saline ; and allowed to settle.  Separate  the  ”sul...
<ul><li>TREATMENT </li></ul><ul><li>Penicillin is the drug of  </li></ul><ul><li>choice :2 to 12 months. </li></ul><ul><li...
  PREVENTION GENERAL CARE OF THE MOUTH.   Brush the teeth at least twice a day. Care of surface grooves, spaces  between t...
Fluoride application Slows the destruction of enamel and helps to repair minor tooth decay damage by demineralization. Sea...
<ul><li>NOCARDIA: </li></ul><ul><li>Nocard.  </li></ul><ul><li>Soil saprophytes. </li></ul><ul><li>Some are  pathogenic : ...
MORPHOLOGY
<ul><li>CULTURE:   </li></ul><ul><ul><ul><li>Slow  growing  aerobe.  (1 – 2 wks). </li></ul></ul></ul><ul><ul><ul><li>N A ...
Pathogenesis  of  Nocardia Soil saprophyte Exogenous infection “ Nocardiosis”
PATHOGENESIS: 1.Cutaneous  Form:   Local abscess, cellulitis.  Lympho cutaneous lesions.  2.Subcutaneous Form: Fungating  ...
5.Systemic Nocardiosis:  Pulmonary  form.    I nhalation.     Immunocompromised :    Corticosteroids   Post Transplantatio...
 
<ul><li>LAB. DIAGNOSIS:  </li></ul><ul><ul><ul><li>Sputum, Pus, Biopsy. </li></ul></ul></ul><ul><ul><ul><li>Microscopy. </...
Nocardia asteroids  colony in tissues. Brown – Benn stain
<ul><li>Actinomyces Nocardia.   </li></ul><ul><li>Anaerobe. Strict aerobe.  </li></ul><ul><li>35 - 37°C. Wide range of tem...
Extrinsic Allergic  alveolitis: Hypersensitive pneumonitis Occupational disease. Synonyms:   Farmers lung.   Mushroom work...
Upcoming SlideShare
Loading in …5
×

Actinomycetales

2,597 views

Published on

PowerPoint presentation

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
2,597
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
56
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Actinomycetales

  1. 1. ACTINOMYCETALES By Dr. P.S.Reddy MD For e-learning
  2. 2. Fungus – like bacteria. This family includes : Actinomyces, Bifidobacterium Rothia, Arachnia. Nocardia, Actinomadura, Streptomyces.
  3. 3. <ul><li>Transitional forms between bacteria & fungi. </li></ul><ul><li>Cell walls with muramic acid. </li></ul><ul><li> </li></ul><ul><li>Prokaryotic nuclei. </li></ul><ul><li>Sensitive to Antibiotics </li></ul><ul><li>Mycelial network with branching filaments </li></ul>
  4. 4. <ul><li>Actinomyces: </li></ul><ul><ul><ul><li>Ray – like appearance. </li></ul></ul></ul><ul><ul><ul><li>Soil saprophytes. </li></ul></ul></ul><ul><ul><ul><li>Commensals in man & animal. </li></ul></ul></ul><ul><li>Morphology: </li></ul><ul><li>Gram positive, </li></ul><ul><li>Non acid fast. A naerobe. </li></ul><ul><li>Branching mycelial forms . </li></ul>
  5. 5. IN THE HOST Sulphur granules in the pus. Granules: Small specks to 5mm. White / Yellowish. Gram staining. Central filamentous mycelium. Club shaped, Gram negative structures GROWTH CHARACTERS
  6. 6. CULTURE Liquid medium: As “fluffy balls” RCM. Thioglycollate broth 1% glucose broth. Solid medium : Blood Agar. BHI. Raised, nodular, Cream colored Spidery colonies resembles molar teeth.
  7. 7. <ul><ul><ul><li>Species causing Actinomycosis </li></ul></ul></ul><ul><ul><ul><li>A. israelii, </li></ul></ul></ul><ul><ul><ul><li>A. meyeri, </li></ul></ul></ul><ul><ul><ul><li>A. naeslundii, </li></ul></ul></ul><ul><ul><ul><li>A. odontolyticum (Dental plaque). </li></ul></ul></ul><ul><ul><ul><li>Rural, Young male persons. </li></ul></ul></ul><ul><ul><ul><li>Agricultural workers. </li></ul></ul></ul><ul><ul><ul><li>Not communicable. </li></ul></ul></ul>
  8. 8. PREDISPOSING FACTORS Periodontal disease, Trauma, Poor oral hygiene Jaw fractures, Maxillo facial surgeries, Periapical odontitis. Tooth decay
  9. 9. <ul><li>Actinomycosis </li></ul><ul><li>Chronic granulomatous Lesion </li></ul><ul><li>with multiple abscesses, fibrosis </li></ul><ul><li>and sinuses. </li></ul><ul><li>External appearance: </li></ul><ul><li>Slowly enlarging hard,red, painless </li></ul><ul><li>lump. </li></ul><ul><li>No lymphatic involvement. </li></ul><ul><li>Blood spread: liver, brain, bone. </li></ul>
  10. 10. <ul><li>CERVICOFACIAL ACTINOMYCOSIS </li></ul><ul><li>Odontogenic in origin. </li></ul><ul><li>Appears as red lump with </li></ul><ul><li>draining sinuses. </li></ul><ul><li>A recent history of tooth </li></ul><ul><li>extraction or signs of </li></ul><ul><li>tooth decay (dental cavity </li></ul><ul><li>or dental caries) or poor </li></ul><ul><li>dental hygiene. </li></ul><ul><li>SUPRA GINGIVAL ACTINOMYCOSIS </li></ul><ul><li>Poor oral hygiene. </li></ul>
  11. 11. Gingival actinomycosis Mycetoma of foot
  12. 12. Thoracic actinomycosis: Sinuses on chest wall, Eroded ribs and spine. Abdominal actinomycosis: Ileocaecal region. Appendix, Colonic diverticula.
  13. 13. X-ray findings of Thoracic Actinomycosis
  14. 14. <ul><ul><ul><li>Pelvic actinomycosis : I U C D. </li></ul></ul></ul><ul><ul><ul><li>Punch actinomycosis : </li></ul></ul></ul><ul><ul><ul><li>Punch on adversaries teeth. </li></ul></ul></ul><ul><ul><ul><li>Gingivitis. </li></ul></ul></ul><ul><ul><ul><li>Periodontitis. </li></ul></ul></ul><ul><ul><ul><li>Dental plaque & Dental caries. </li></ul></ul></ul><ul><ul><ul><li>Mycetoma. </li></ul></ul></ul>
  15. 15. Laboratory diagnosis: 1. Pus 2. Sputum (not reliable) Specimen + saline ; and allowed to settle. Separate the ”sulphur granules” Do staining & culture. 3. Needle aspiration: From sinuses 4. Open biopsy: For HPE by H & E staining.
  16. 16. <ul><li>TREATMENT </li></ul><ul><li>Penicillin is the drug of </li></ul><ul><li>choice :2 to 12 months. </li></ul><ul><li>Surgical therapy is </li></ul><ul><li>often indicated for </li></ul><ul><li>curettage of bone, </li></ul><ul><li>resection of necrotic </li></ul><ul><li>tissue, excision of </li></ul><ul><li>sinus tracts. </li></ul>
  17. 17. PREVENTION GENERAL CARE OF THE MOUTH. Brush the teeth at least twice a day. Care of surface grooves, spaces between teeth. Dentist consultancy every six months. MOUTH CARE IN OLDER ADULTS. Bridges and dentures must be kept clean and should be relined. MOUTH CARE IN CHILDREN. Don’t allow the child to fall asleep with a milk.
  18. 18. Fluoride application Slows the destruction of enamel and helps to repair minor tooth decay damage by demineralization. Sealants A thin plastic coating that is painted over the grooves to prevent entrapment of food particles. Diet Sugar and Starch. &quot;swish and swallow&quot; after meal.
  19. 19. <ul><li>NOCARDIA: </li></ul><ul><li>Nocard. </li></ul><ul><li>Soil saprophytes. </li></ul><ul><li>Some are pathogenic : </li></ul><ul><li>N. asteroides, </li></ul><ul><li>N. brasiliensis, N.madurae (non acid fast) </li></ul><ul><li>Morphology: </li></ul><ul><li>Resembles rapidly growing Mycobacteriae. </li></ul><ul><li>Branching filamentous (bacillary and coccal forms). </li></ul><ul><li>Weakly Acid fast (1% H2 SO4) </li></ul><ul><li>Gram positive. </li></ul>
  20. 20. MORPHOLOGY
  21. 21. <ul><li>CULTURE: </li></ul><ul><ul><ul><li>Slow growing aerobe. (1 – 2 wks). </li></ul></ul></ul><ul><ul><ul><li>N A : Dry, granular, wrinkled colonies </li></ul></ul></ul><ul><ul><ul><li> with yellow to red pigment. </li></ul></ul></ul><ul><ul><ul><li> “ Star shaped colony” </li></ul></ul></ul><ul><ul><ul><li>B H I : Trypticase soy agar is Better. </li></ul></ul></ul><ul><ul><ul><li>Sabourad’s Dextrose Agar. </li></ul></ul></ul>
  22. 22. Pathogenesis of Nocardia Soil saprophyte Exogenous infection “ Nocardiosis”
  23. 23. PATHOGENESIS: 1.Cutaneous Form: Local abscess, cellulitis. Lympho cutaneous lesions. 2.Subcutaneous Form: Fungating tumor like masses. Sinus formation. Mycetoma. 3.Nocardiosis with liver transplantation 4.Ocular nocardiosis followed by trauma.
  24. 24. 5.Systemic Nocardiosis: Pulmonary form. I nhalation. Immunocompromised : Corticosteroids Post Transplantation Immunosuppressive therapy. Aleolarproteinosis. H I V infection. Multiple confluent abscesses. Empyema Heals with little /no fibrosis Haematogenous spread Brain lesion.
  25. 26. <ul><li>LAB. DIAGNOSIS: </li></ul><ul><ul><ul><li>Sputum, Pus, Biopsy. </li></ul></ul></ul><ul><ul><ul><li>Microscopy. </li></ul></ul></ul><ul><ul><ul><li>Culture. </li></ul></ul></ul><ul><li>TREATMENT: </li></ul><ul><ul><ul><li>Sulphonamides. </li></ul></ul></ul><ul><ul><ul><li>Amikacin. </li></ul></ul></ul><ul><ul><ul><li>Surgical drainage. </li></ul></ul></ul>Grams staining Acid fast staining
  26. 27. Nocardia asteroids colony in tissues. Brown – Benn stain
  27. 28. <ul><li>Actinomyces Nocardia. </li></ul><ul><li>Anaerobe. Strict aerobe. </li></ul><ul><li>35 - 37°C. Wide range of temperature. </li></ul><ul><li>Oral commensal. Saprophyte (soil) </li></ul><ul><li>Non – acid fast. Acid fast (weakly) </li></ul><ul><li>Endogenous . Exogenous . </li></ul><ul><li>No lymphatic involvement. Lymphatics involved. </li></ul><ul><li>No pigment usually. Pigment produced. </li></ul>
  28. 29. Extrinsic Allergic alveolitis: Hypersensitive pneumonitis Occupational disease. Synonyms: Farmers lung. Mushroom worker’s lung. Bagassosis. Caused by: Faenia rectivirgula Thermophilic actinomyces spp. Inhalation of mouldy vegetable matter.

×