Actinomyces

Actinomyces israelii

Gram positive filamentous bacilli

Obligate anaerobe
Actinomyces actually means "ray fungus" in Greek Previously thought as fungi, but they Bacteria

Sulfur granules
Important species A.Israellii

Sulphur granules sulphur granule is shown in the middle of the image Courtesy by Dr.Alvin fox

Epidemiology
Endogenous Gums, GIT and female ganital tract Opportunistic,following disruption of mucosal barriers by trauma, surgery or infection No person to person transmission

Clinical features
Suppurative and granulomatous multiple abscesses and interconnecting sinus tracts Micro colonies sulfur granules bone involvement

Common areas of lesions

Cervicofacial Thoracic Abdominal Pelvic Cranial

Actinomyces infection

Diagnosis
Slow growth (up to two weeks or more)

Colonies have "molar tooth" appearance on agar

Sulfur granules

Treatment
Penicillin Surgery and debridement

Nocardia

Nocardia
Gram positive- weak Acid Fast- weak Filamentous branching Strict aerobe Blood Agar- 1-4 days produce colonies (slow growth) Rough, irregular, chalky appearance colonies 2 impt organisms: Nocardia Asteroids- Pulmonary Nocardiosis Nocardia Brazilicnes- Cutaneous Nocardiosis

Nocardia

Epidemiology Present in soil, intestines of humans & animals Inhalation- Pulmonary Nocardiosis Thorn Picks- Cutaneous Nocardiosis No case to case transfer

No virulent factors known

No pathogenesis known

Clinical Features
Pulmonary Nocardiosis Acute/chronic/relapsing-bronchopneumonia Cavities in lungs In brain circulation- brain abscess Cutaneous Nocardiosis Cellulitis Sinus tract-mycetoma- progressive chronic granulmatous infection

Diagnosis
Clinically Gram stain- filamentous Acid Fast- take the staining Blood Agar Culture- aerobic conditions Pigment: white-orange Treatment Sulfanamides