Actinomycosis is a chronic disease that can provoke different subspecies of actinomycetes. This infection affects various organs, tissues. Infiltrates are formed on them, they start to swim, then fistulas arise. This dangerous damage to the epidermis is also known as "radiation-fungal disease".
Features of the disease
We consider the defeat is contagious, it is characterized by a primary chronic course. In the areas of infection with fungus in actinomycosis there are dense granulomas, abscesses, fistulas. Defeat the tissues provoke radiant fungi. To make an accurate diagnosis, study the detachment taken from the lesion sites. It exhibits a characteristic mycelium of fungi.
Actinomycosis in humans( photo)
Classification of actinomycosis
The classification of actinomycosis was developed by specialists taking into account such factors as the location of the infection. The disease is divided into the following forms:
- cutaneous( skin actinomycosis). Occurs as a secondary lesion, in which case the infection is considered a consequence of the progression of the lesion in other organs. Recognize it easily at a time when infiltrates fall inside the subcutaneous tissue. Fistulas form on the epithelium;
- cervico-maxillofacial form of actinomycosis. The most common. It has 2 subspecies: muscular, cutaneous;
- is abdominal. I got the third place in frequency. Initially, lesions affect such areas: appendix, ileocecal region, then go to the large intestine. Occasionally, the infection initially affects the esophagus, small intestine, stomach. The disease can go to the spine, kidneys, liver, even the abdominal wall. Without proper therapy, lethality reaches 50% of cases;
- joints, bones. Very rare form. It begins because of the spread of infiltration on the bones, joints from neighboring organs. Osteomyelitis of the pelvis, shin, spine with destruction of bones, the appearance of sequestrants are often encountered;
- Thoracic. Patients are at risk of death if they do not start therapy in time;
- CNS. The form of the disease is very infrequent;
- genitourinary. In medical practice is rare;
- of the foot ( Maduromatosis, Madurian Foot, Mycetoma).
The causes of actinomycosis are discussed in the video below:
Symptoms
Experts have not yet determined the exact duration of the incubation period of the pathology we are considering. At its initial stage the patient feels well, his state of health deteriorates noticeably if the internal organs become infected. Cachexia may also occur.
More often fungus affects such areas:
- buttocks;
- submandibular;
- sacral region.
Symptoms differ in view of the area that actinomycosis was affected:
- Skin. It is inherent in the formation of seals inside the subcutaneous tissue. Initially, they are dense, soften with time, open up, form hard-healing fistula. The form of these seals is spherical, they do not cause pain. In the pus fistula, drusen fungi can be kept. This form of pathology is also characteristic of a change in the color of the epidermis to bluish-purple.
- The cervico-maxillofacial form. It includes two types: muscular, dermal. The muscular form extends to the intermuscular cellulose. Often chewing muscles are affected. In this case, the face acquires an asymmetry, the fistulas arise from which the blood-purulent liquid is removed. On the neck appear rollers( peculiar changes in the epidermis).Infiltrates( globose, hemispherical) are localized in the subcutaneous tissue when a cutaneous appearance of the disease occurs. Fungus affects the tongue, eye sockets, cheeks, lips, tonsils, larynx, trachea.
- Abdominal form. It is characterized by the imitation of surgical diseases( appendicitis, intestinal obstruction).If the rectum is affected, symptoms of paraproctitis appear. If the fungus affects the front wall of the abdomen, intestinal fistulas develop on the epidermis.
- Actinomycosis of bones, joints. Bone lesions are characterized by signs of osteomyelitis. When infecting joints, there is no violation in their functionality. If the infiltrate has spread to the surface of the epithelium, fistulas arise. Thoracic actinomycosis. Pathology develops gradually. The patient begins to worry about subfebrile temperature, cough, weakness, initially dry, through time with phlegm( mucus, pus).Cough is with a trace of blood. With the chest wall, pleura, dermis, burning pains occur, swelling, fistulas are formed, communicating with the bronchi.
- Actinomycosis of the central nervous system. It manifests itself as single, multiple abscesses. With CT, conducted with a contrast agent, abscesses are foci of reduced density, they have a round, irregular shape. Around these foci there are wide ring-shaped shadows.
- Genitourinary Actinomycosis. This is a secondary lesion, it occurs after the infiltration is spread during the progression of the abdominal form of the disease.
- Actinomycosis of the feet. It initially starts with the sole. It has the appearance of dense, bounded nodes, the epidermis on which initially unchanged, and then compacted, acquires a brownish, reddish-violet color. The defeat extends to the foot, which swells, changes shape. The nodes go into deep fistulas, from which a foul-smelling liquid is discharged( purulent, bloody, serous-purulent).Infection can move upward, touch the shin( its tendons, bone, muscle fibers).
Causes of
The fungi of the genus Actinomyces can often be found in nature. They are considered to be the causative agents of the actinomycosis in question. These fungi live in hay, plants, soil, straw. The ingress into the human body goes in such ways: through the injured epidermis;with food;by inhalation.
Most often mushrooms of this kind do not provoke the onset of the disease, they are present in the role of saprophyte flora inside the oral cavity, on the eye mucosa. Their parasitism is activated at the onset of the inflammatory process in certain parts of the body:
- respiratory organs;
- mouth;
- GASTROINTESTINAL TRACT.
Infectious disease of the epidermis sometimes develops as a primary infection( fungi penetrate through the wounds on the epidermis), as well as in the secondary( the infection passes to healthy tissues from the affected: muscles, lymph nodes, teeth, tonsils, mammary glands.other types of diagnostics of actinomycosis
Diagnosis
If the pathology clinic is well developed, doctors will not have any difficulties in diagnosing, but it is important for doctors to detect this disease at an early stage of development.
For an accurate diagnosis, it is necessary to separate, taken from fistulas. To take a sample, percutaneous puncture of the affected organ can also be performed. Preliminary diagnosis specialists can put on the basis of the results of microscopy. Thanks to this study, the drusen of the fungus can be found in the sample. To determine the type of actinomycetes that provoke the disease, RIF( immunofluorescence reaction) is performed with specific antigens.
It is difficult to diagnose when there are no druses in the material being studied. This is typical in 75% of cases. Here, only sowing biopsy material, pus on Sabur's medium, will help. This study can be delayed for 2 weeks.
This video will tell about the treatment of actinomycosis with new means:
Treatment of
- The therapy of the disease we are considering is carried out by the introduction of actinolysate( intramuscularly, subcutaneously).
- Simultaneously, the specialist prescribes antibiotic therapy, which is necessary to prevent re-infection, suppression of the accompanying flora.
- In addition, there is general restorative, detoxification therapy.
Therapeutic
In the actinomycosis, specialists also resort to therapeutic treatment. It consists of the following procedures:
- iodine electrophoresis;
- electrophoresis of actinolysate;
- UV of the epidermis( area of injury).
Medication
- In the treatment of actinomycosis, experts recommend penicillin preparations. For 20-40 days, take 10-12 million U / day. After this course, it is necessary to take 1 million U / day 2-3 months.
- If the patient is intolerant of penicillin, he is prescribed tetracycline, erythromycin( 2 g / day).Actinolysate must be administered subcutaneously, intramuscularly twice a week( 2 g / day).The course includes 20-25 injections.
Operation
If abscesses are formed, they need to be opened.
- When treating the disease, actinomycosis affecting the peritoneum, drainage of the abdominal cavity may be necessary.
- In case of lung damage, lobectomy, drainage of the pleural cavity may be necessary.
Prevention of the disease
There are no specific preventive measures. To prevent the onset of the disease it is possible:
- Observing personal hygiene.
- Timely curing diseases of teeth, tonsils, gastrointestinal tract, respiratory system, oral cavity.
- Warnings of epithelial injuries.
Complications of
What actinomycosis can cause complications? The course of the disease over a long period threatens the development of amyloidosis of internal organs. The maxillofacial-facial form is dangerous by the spread of actinomycosis to the brain, organs of the thoracic cavity.
Forecast
Easier to treat is cervico-maxillofacial form of the disease. Fatal outcome threatens with actinomycosis of the central nervous system, internal organs. After the treatment of patients, relapses are possible.
In this video, a person shares his experience in the fight against actinomycosis, and the doctor comments on what he heard: