Cervico-facial Actinomycosis

What is Cervico-facial Actinomycosis?

Actinomycosis (synonyms: radiant fungal disease; Aktinomykose – German; actinomycose – French) is a chronic disease caused by various types of actinomycetes. It is characterized by the defeat of various organs and tissues with the formation of dense infiltrates, which then suppurate with the appearance of fistulas and a peculiar skin lesion.

Causes of Cervico-facial Actinomycosis

Pathogens – various types of actinomycetes, or radiant mushrooms. The main ones are the following: Actinomyces Israeli, Actinomyces bovis, Actinomyces albus, Ac. violaceus. Actinomycetes grow well on nutrient media, forming colonies of irregular shape, often with radiant edges. Pathogenic for many types of agricultural and laboratory animals. In pathological material they are found in the form of drusen, which are yellowish lumps with a diameter of 1-2 mm. Microscopy in the center of the drusen reveals an accumulation of filaments of mycelium, and on the periphery – bulb-shaped swellings. When stained with hematoxylinoosin, the central part of the drusen is colored blue and the flasks pink. There are Druze, in which there is no rim of bulb-shaped cells. Actinomycetes are sensitive to benzylpenicillin (20 U / ml), streptomycin (20 μg / ml), tetracycline (20 μg / ml), chloramphenicol (10 μg / ml) and erythromycin (1.25 μg / ml).
Epidemiology. Actinomycosis is common in all countries. They get sick people and farm animals. However, cases of human infection from sick people or animals are not described.

The causative agents of actinomycosis are widespread in nature (hay, straw, soil, etc.). Actinomycetes are often found in healthy people in the oral cavity, plaque, tonsil lacunae, on the mucous membrane of the gastrointestinal tract. Both exogenous and endogenous methods of infection are important.

Pathogenesis during Cervical-facial Actinomycosis

The most common is the endogenous route of infection. Actinomycetes are widespread in nature, in particular on plants, can enter the body with plants and be on the mucous membranes as saprophyte. The transition of actinomycetes from a saprophytic to a parasitic state is facilitated by inflammatory diseases of the mucous membranes of the oral cavity, respiratory and gastrointestinal tract. At the site of actinomycetes introduction, an infectious granuloma is formed, which grows into the surrounding tissues. Abscesses arise in granulations, which, breaking through, form fistulas. Skin lesions are secondary.

In the formation of suppuration, a secondary, mainly staphylococcal infection plays a role. Radiant mushroom antigens lead to specific sensitization and allergic rearrangement of the body (delayed or tuberculin type hypersensitization), as well as the formation of antibodies (complement binders, agglutinins, precipitins, etc.).