II. Etiologies

  1. Actinomycosis israeli (most common)
  2. Actinomycosis bovis

III. Pathophysiology

  1. Chronic local or systemic Bacterial, Granulomatous disease

IV. Symptoms

  1. Weight loss
  2. Weakness

V. Signs

  1. Fever
  2. Disseminated organ involvement
    1. Head and neck (Cervicofacial) lumps and fistula tracts after facial Trauma
    2. Abdominal mass after surgery (with fistula in some cases)
    3. Pelvic from Tuboovarian Abscess (and PID), often related to IUD
    4. Lung Mass
  3. Skin
    1. Multiple sinus tracts draining pustular discharge
    2. Pus contains sulfur granules

VI. Lab

  1. Gram Stain of sulfur granules
    1. Gram Positive fungi
  2. Anaerobic Blood Culture

VII. Management

  1. First-Line
    1. FIRST: Ampicillin 16.5 mg/kg IV tid (or penicllin G 2.5 to 5 MU IV qid) for 4-6 weeks
    2. THEN: Penicillin VK 2-4g/day divided qid for 3-6 months
  2. Alternative agents
    1. Doxycycline 100 mg oral or IV twice daily
    2. Clindamycin 600-900 mg IV every 8 hours

VIII. Resources

IX. References

  1. (2015) Sanford Guide to Antibiotics, IOS App accessed 4/21/2016

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Related Studies

Ontology: Actinomycosis (C0001261)

Definition (NCI) An infectious process caused by bacteria of the Actinomyces species. It is characterized by the formation of purulent and painful abscesses in the mouth, lungs and gastrointestinal tract.
Definition (MSH) Infections with bacteria of the genus ACTINOMYCES.
Concepts Disease or Syndrome (T047)
MSH D000196
ICD9 039.9, 039
ICD10 A42 , A42.9
SnomedCT 266185008, 187335006, 154314007, 186405006, 50508009, 238416009, 186402009, 11817007
English Actinomyces Infection, Actinomyces Infections, Actinomycoses, Actinomycosis, Infection, Actinomyces, Infections, Actinomyces, Actinomycotic infections, Actinomycotic infection of unspecified site, Actinomycosis unspecified site, Actinomycosis unspecified site NOS, Actinomycosis, unspecified, [X]Actinomycosis, unspecified, INFECT ACTINOMYCES, ACTINOMYCES INFECT, actinomycosis (diagnosis), actinomycosis, Actinomycosis [Disease/Finding], actinomycoses, actinomyces infection, actinomycotic infection, Actinomycotic infectious disorders, [X]Actinomycosis, unspecified (disorder), Actinomycosis unspecified site NOS (disorder), Actinomycosis (disorder), Actinomycosis unspecified site (disorder), Actinomycotic infection, Actinomycotic infection (disorder), infection; Actinomyces, infection; actinomycotic, actinomycotic; infection, Actinomyces; infection, Actinomycosis, NOS, Actinomycotic infection, NOS, Actinomycosis NOS
Italian Patologie infettive da Actinomiceti, Infezioni actinomicotiche, Infezione actinomicotica di sede non specificata, Infezioni da Actinomyces, Actinomicosi
Dutch actinomycose op niet-gespecificeerde plaats, actinomycotische infecties, Actinomyces; infectie, actinomycotisch; infectie, infectie; Actinomyces, infectie; actinomycotisch, Actinomycose, niet gespecificeerd, actinomycose, actinomycotische infectieuze aandoeningen, Actinomyces-infectie, Actinomycose, Mycose, actino-
French Infections actinomycosiques, Infection actinomycosique d'un site non précisé, Troubles infectieux actinomycotiques, Actinomycose, Infections à Actinomyces
German aktinomykotische Infektion unspezifischer Stelle, aktinomykotische Infektionen, Aktinomykose, nicht naeher bezeichnet, Aktinomykotische Infektionserkrankungen, Aktinomycesinfektionen, Aktinomykose
Portuguese Infecções actinomicóticas, Infecção actinomicótica de localização especificada, Afecções actinomicóticas infecciosas, Actinomicose, Infecções por Actinomyces
Spanish Infección actinomicótica de localización no especificada, Infección actinomicótica, actinomicosis de localización no especificada (trastorno), [X]actinomicosis, no especificada (trastorno), actinomicosis (concepto no activo), actinomicosis de localización no especificada, SAI (trastorno), [X]actinomicosis, no especificada, actinomicosis de localización no especificada, SAI, actinomicosis de localización no especificada, actinomicosis, infección actinomicótica (trastorno), infección actinomicótica, Infecciones actinomicóticas, Actinomicosis, Infecciones por Actinomyces
Japanese 部位不明の放線菌感染, ホウセンキンカンセンショウ, ブイフメイノホウセンキンカンセン, ホウセンキンショウ, アクチノマイセス感染症, 放線菌症, アクチノミセス感染症, アクチノミセス症, 放線状菌症, アクチノマイセス症, 放線菌感染症
Swedish Strålsvampsjuka
Czech aktinomykóza, Onemocnění způsobená aktinomykotickou infekcí, Aktinomykóza, Aktinomykotické infekce, Aktinomykotická infekce v blíže neurčené lokalizaci
Finnish Aktinomykoosi
Korean 방선균증, 상세불명의 방선균증
Polish Promienica, Aktynomykoza
Hungarian actinomycosis, Actinomycoticus fertőzéses betegségek, Nem meghatározott elhelyezkedésű actinomycoticus fertőzés, Actinomycoticus fertőzések
Norwegian Strålesoppinfeksjon, Aktinomykose