Actinomycosis is a bacterial infection caused by Actinomyces species. It usually occurs following a break in the skin or mucous membranes that allows the bacteria to enter and form lumpy masses or granulomas. Symptoms vary depending on the infected area but may include lumps, draining sinuses, fever, and weight loss. Diagnosis involves culture, biopsy or imaging tests. Treatment involves long-term high dose antibiotics such as penicillin for several months to over a year to prevent recurrence or relapse. Prevention focuses on good oral hygiene and prompt treatment of wounds.

1. Topic overview
 Gen. Info
 History
 Etiology (Human &
Animals)
 Host range
 Epidemiology
 Viability & Susceptibility
 Patho-Physiology
 Pathogenic Mechanism
 Transmission
 Pathogenesis
 Clinical Manifestations
 Human
 Animals
 Treatment
 Diagnosis
 Antimicrobial Therapy
 Alternative Treatment
 Prevention and Control
 Prevention
 Exposure controls
 Handling and Storage
 References

2. ACTINOMYCOSES
Presentedby:
KonicaMencias Lim

3. General
Information

4. history
 1877- Otto Bollinger decribed presence of A . bovis in
cattle
 1878 – James Israel discovered A . israeli in humans
 1879- Hartz first observed the microscopic appearance of
sulfur granules
 1890- Eugene Bostroem isolated C. A. from a culture of
grain, grasses & soil
 1939- Bergey classified the organism as bacterial but it
remained classed as a fungus in the 1955 ed. of the
Control of Communicable Diseases

5. Etiology
(In Animals)
causative organisms are non-motile, non-spore
forming, non-acid fast, Gram (+) pleomorphic,
anaerobic to microaerophilic filamentous rods
belonging to the Actinomycetaceae family.
Requires mucosal break and copathogens to
cause infection
The filaments are <1 µm in diameter, as
opposed to fungal filaments which are >1 µm in

6. Etiology
(In Humans)
 Polymicrobial etiologic agents belonging to different
genera
(Actinomyces, Propionibacterium, and Bifidobacterium)
 Causative Actinomyces sp (most commonly A. israelii),
are often present commensally on the gums, tonsils,
and teeth.

7. PIGS
CATS
DOGS
Host range
HUMANS
MARINE MAMMALS
CATTLE
HORSES

8. Worldwide distribution, commonly found in
poor regions or of low economic status and
poor hygiene.
More common in males (3:1)
1-28% mortality rate

9. β -lactam antibiotics (highly sensitive)
tetracyclines, macrolides, lincomycins, fusidi
c acid. and vancomycin (high to moderate)
some strains are resistant to
aminoglycosides peptide antibiotics metronid
azole rifampicin (A . Naeslundii )

10. SUSCEPTIBILITY TO
DISINFECTANTS
Actinomyces spp are shown to be susceptible
to:
 Low concentrations of chlorine
 70 % ethanol
 Phenolics
 2% aqueous glutaraldehyde
 peracetic acid (0.001% to 0.2%)

11. PHYSICAL INACTIVATION
 exposure to UV rays or by heating to 55--
65 °C
inactivated by moist heat (121°C for 15 min -
30 min)
dry heat (160-170°C for 12 hours)

12. Pathophysiology

13. Pathogenic Mechanisms
of Some Actinomycesspp.

15. Types offimbriaein some
Actinomyces spp.
type 1 fimbriae
mediate bacterial attachment to the tooth surface
and saliva coated hydroxyapatite
type 2 fimbriae
associated with a lectin activity that mediates
adhesion to epithelial cells and PMN’s , as well
as coaggregation with other bacteria.

17. transmission
 Commensals of oral cavity, GIT, and female genital
tract.
 Requires a break in the integrity of mucous
membranes and presence of devitalized
tissue to invade deeper body structures
and to cause illness.
 Requires copathogens
 IP:
varies from several days to several years after colon

18. TISS
UE
fibrosis
Pus
and
abcess
formatio
n
Intense
inflammat
ory
response
Broken
tissue
Sinus
tract
formatio
n

19. Any
Questions
So far?

20. Manifestations
In humans

21. Decayed teeth,
recent dental
surgery, etc
Soft tissue
swelling
fistulization
bacteremia
Cervicofacial

22. Clinical signs
swollen lumps on cheek or neck,
reddish or bluish -
coloured skin over the lumps
a high temperature (fever) of 38ºC (100.4ºF)
or above

26. Clinical signs
a high temperature (fever) of 38ºC (100.4ºF)
or above
emaciation
tiredness (fatigue)
inappetence
dyspnea
chest pain

28. Accidental
Swallowing
Of sharp
objects
Secondary
complications
infectio
n
A
B
D
O
M
I
N
A
L

30. Clinical signs
mild fever (no higher than 38ºC (100.4ºF)
weight loss
Fatigue
constipation or diarrhoea
abdominal pain
nausea and vomiting
noticeable mass/lump in lower abdomen

31. IUCD
uterus
infection
lower abdominal pain
irregular or abnormal vaginal
bleeding or vaginal discharge
Inappetence
mild fever
noticeable mass or lump in th
e pelvis
Clinical signs

33. CNS
ACTINOmycoses
Cervicofacial
• Direct
dissemination
Abdominopelvic
• Hematogenous
spread/bacteremi
a

35. In animals

36. injury
• hay
• Wire
• sticks
Lumpy
jaw
• Mandible
• Maxillae
• Other bony
tissues
fistula
• Mass
• ulceration
A.bovis

37. Specie Affected animals Transmission Clinical Signs/Manifestations
A.
actinoid
es
cattle
Secondary
invader
Calves: enzootic pneumonia
Bulls: seminal vasculitis
A.israelii
man
Trauma,
injury,/brea
k
Aspiration,
inspiration
Chronic granulomatous
infxns
Swine,
cattle
Pyogranulomatous lesions
A.naeslundii
Several
animal
spp.
Trauma/inj
ury
Suppurative infxns
swine abortion

38. A.suis swine
Trauma,
injury, or
break
Pyogranulonmatous porcine
mastitis, deep ventral SQ
granulomatous lesions,
occassional pyogranulomatous
infxns in lungs, spleen, kidneys
and other organs
A.
hordeovulneris canine inhalation
pyogranulomatous pleuritis, perito
nitis, visceral abscesses, or s
eptic arthritis
A. viscosus canine
Bite wounds
or foreign
bodies
Localized SQ abcesses in head,
neck, thorax and abdomen,
Specie Affected animals Transmission Clinical Signs/Manifestations

39. Treatment,

40. Diagnosis
Cervicofacial
Bacterial inoculation,
culture & isolation
x- ray
Abdomino-pelvic
Exploratory
laparotomy
Histology
MRI, CT Scan, X-rayThoracic
Biopsy
CT scan
Open surgery
CNS
Biopsy
MRI, CT Scan, X-ray

42. Antimicrobial therapy
(in humans)
Penicillin G
Adult:Penicillin G - 12-24 million U/d IV by
continuous infusion or in divided doses
q4h for 1-2 wk
 then switch to PO (penicillin VK) for 6-12
mo

43. Antimicrobial therapy
(if there is hypersensitivity and resistant to
PenG)
 Amoxycillin/Clavulanic
acid
 Adult: 500 mg PO
q8h, or 875 mg PO
q12h),
 Ceftriaxone
Adult: 2 g IV/IM q12-
24h; not to exceed 4
g/d,
 Clindamycin
 Doxycycline
Adult: 100 mg PO/IV
q12h
 Imipenem/Cilastin
Adult: 500 mg-1000mg
IV q8h; not to exceed
4 g/d,

44. Antimicrobial therapy
(in animals)
Antimicrobials (like injectable penicillin,
Sulfonamides, Tylosin, and
streptomycin).
Potasium Iodide (4-8 gm daily orally).
Sodium Iodide 15-30 g in 250-500 ml
distilled water –IV route.
Isoniazid (20mg/kg BW).

45. Other alternative treatment

46. Prevention

47. prevention
 Maintain oral hygiene
 Change IUCD every 5years
 Reduce alcohol consumption

48. EXPOSURE CONTROLS

49. Handling and storage
SPILLS
 Allow aerosols to settle and, wearing protective clothing, gen
tly cover spill with paper towels andapply an appropriate disi
nfectant, starting at the perimeter and working towards the c
entre. Allow sufficient contact time before clean up
 DISPOSAL
 decontaminate all contaminated wastes before disposal via
autoclave, chemical disinfection, gamma irradiation, or inci
neration
 STORAGE

50. Thank you
for listening!

51. 2016. http://www.phacaspc.gc.ca/labbio/res/psdsftss/msds2eeng.php
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REFERENCES

52. Any
Questions?