Lecture of the fungus Actinomycosis

2021-02-05 12:00 AM

Diseases of the skin, mucosa when the mucosa or skin has micro-shock Actinomyces is easy to infect and develop to cause disease, the pathogen can be through food, pathogenic cereals in the oral mucosa.

Leaven

The disease was discovered by Nocard and Lucet in 1888. The cause of the disease is some species of Actinomyces such as A. wolframite and Actinomyces which are microorganisms between bacteria and fungi or create fake mycelium, with a very small diameter. (less than 1µm), sometimes creating junk filaments, so it is named "ray fungus" or bacteriophage, catching the gamut (+). Actinomyces usually live-in rare gases, sensitive to some antibiotics, usually present in plants, soil, water. On the human body often appears in the skin, mouth, causing disease when conditions are favourable.

Clinical symptoms

Diseases of the skin, mucous membranes: when the mucosa or skin has micro-shock, Actinomyces can easily infect and develop to cause disease. Pathogens can be through food, cereals that cause disease in the oral mucosa, tongue, throat, oesophagus... On the other hand, the pathogen can reside in decayed teeth, tartar or dentures, when conditions are favourable. (extraction of teeth) disease appeared.

Diseases in the neck, face, chest, abdomen: skin lesions in these areas are usually secondary to the subcutaneous foci of the neck or jaw. Initially appears one or more lumps under the skin, usually firm, painless, attached to the deep base, then stick to the upper skin, usually pink, then gradually become a soft, squishy gum in the middle and pus. The clumps can clump into a patch, purple-red, soft, firm, with a lot of fluid, pus and blood on the way. In pus, there are usually small, opaque yellow particles. The disease usually progresses slowly, persistently, without timely treatment, the disease is more and more widespread, deep down to the bone that can be detected by X-rays, spread to the viscera, especially without the lymph nodes.

Pulmonary Actinomyces: Approximately 10% of patients develop pneumonia by inhalation of pathogens. Nervous sphincter develops in the hilum area, from where the disease can spread to the pleura and then to the chest skin. Onset patients often have a fever, shortness of breath, respiratory failure. The lesions develop, causing the skin of the chest to become swollen, and internal discharge holes appear, which encroach on small, yellow "mushroom seeds". Detecting the disease can be X-ray, lesions are usually in the lower half of the spectrum, in the hilum, sometimes with effusion of pleura.
Gastrointestinal fungal diseases: pathogens penetrate through the digestive tract.

Actinomyces or concentrated in low motility areas such as the cecum, appendix, easily cause inflammation of these organs.

In addition, fungi can cause kidney disease, liver disease, gynaecological disease, nervous system.

Testing and diagnosis

Direct microscopy: the specimen is fluid from the fistula, a mucous membrane with a fungal infection, smeared in 20% KOH or gram stained. Seeing "mushroom seeds" consisting of many thin, small strands like roots, surrounded by fibres radiating like rays. The diameter of the fibres is usually less than 1µm, without a wall, catching gram (+) purple.

Culture: The specimens can be cultured on BHI medium, Bouillon medium, and at a temperature of 370 C under anaerobic conditions, fungi can grow after 8-10 days.

Histology: it is possible to biopsy when there is a suspected fungal infection of the organs, PAS or hematoxylin-eosin staining will be observed.

Differential diagnosis: need differential diagnosis with bone marrow osteomyelitis, tuberculosis, appendicitis, malignant tumours.

Treatment

Antibiotics such as penicillin in millions of units for 30-50 days can be used. May be combined with metronidazole 0.25 x 3 tablets/day monthly. Can combine surgery and jealousy. In classical treatment, often use oral potassium iodide 6-12 grams/day or a combination of sulfamic with antibiotics.