DOCSLIB.ORG

Tuberculosis, Leprosy, Actinomycosis, Nocardiosis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Tuberculosis, Leprosy, Actinomycosis, Nocardiosis Granulomatous infections: tuberculosis, leprosy, actinomycosis, nocardiosis Prof. dr hab. n. med. Beata M. Sobieszczańska Wrocław Medical University Dept. of Microbiology Granulomatous inflammation Chronic inflammatory reaction – protective response to chronic infection or foreign material preventing dissemination and restricting inflammation Tuberculous M. tuberculosis M. africanum Typical M. bovis Noncultivable M. leprae Mycobacterium Skin ulcers M. ulcerans, M. balnei Atypical (MOTT) slow growers Saprophytic M. kansasii M. phlei, M. smegmatis M. scrofulaceum M. avium-intracellulare (MAI) Rapid growers: M. fortuitum, M. chelonei General characteristics: ► slender curved-rods ► nonmotile ► non-spore forming obligate aerobes ► fastidious (enriched special culture media) ► slow generation time (18-24 h) ► facultative intracellular pathogens Acid fast = retains carbolfuchsin dye when decolorized with acid-alcohol Acid fast bacteria: Mycobacterium, Nocardia High concentration of lipids in the mycobacterial cell wall is associated with: • Cell wall impermeability • Antibiotic resistance • Resistance to killing by acids & alkalis • Resistance to osmotic lysis via complement deposition • Resistance to lethal oxidation • Survival inside of macrophages • Slow growth (lipids determine hydrophobic cell surface that causes mycobacteria to clump & inhibits nutrients access) – infection is an insidious, chronic process taking several weeks or months to become apparent Microscopy – acid fast Ziehl-Neelsen = acid fast staining Auramine staining - more sensitive than an acid fast stain requires fluorescence microscopy Virulence factors The ability to survive within macrophages (superoxide dismutase, catalase, mycolic acids) Cord factor (wax C) = responsible for the growth as serpentine cords / present only in M. tuberculosis toxic to mammalian cells & inhibits PMNs migration Mycobacteria do not produce toxins !!! Infects humans & wide Mycobacterium host range of animals africanum (cattle, nonhuman Humans primates, cats, goats, Airborne transmission dogs, pigs etc.) - East & West Africa worldwide • Ingestion of Mycobacterium tuberculosis MTB contaminated milk from infected cows Humans are the only reservoir for the bacterium Mycobacterium Optimal conditions for bovis transmission include: overcrowding poor public hygiene Droplet nuclei • IFNƔ activates macrophages making them capable of destroying MBT • The cell mediated immune response (delayed hypersensitivity) control the infection Primary tuberculosis • Caseous necrotic tissue • Most patients with primary tuberculosis are asymptomatic & the granulomas resolve Caseation – a form of necrosis characteristic of tuberculosis in which diseased tissue form a firm, dry mass like cheese in appearance Primary infection • The patient will heal & a scar will appear in the infected loci • The bacteria at this time goes into a dormant state, as long as the person's immune system remains active & functions normally there is no disease symptoms • When a person's immune system is depressed a primary progressive tuberculosis will develop Primary Tuberculosis Primary tuberculosis: – Self limiting disease – no symptoms, recovery or mycobacteria remain in a dormant state Primary progressive TB in 5% of infected – Miliary TB & TB meningitis – Common in malnourished children – 10% of adults (immunosuppressed individuals) Milliary lesions which are small granulomas, resemble, millet spread throughout the lung fields Patients are highly contagious Milliary tuberculosis Secondary tuberculosis • Reactivation (endogenous in 99% of cases) or reinfection (rare) • Tubercules liquefy & MBT starts to multiply extracellulary • Walls of nearby bronchi become necrotic & rupture = cavity formation and MBTspreading Cavitary Secondary TB Extensive cavitation of multiple granulomas of lung are typical for secondary tuberculosis Tuberculous spodylitis- Potts disease PRIMARY & POST-PRIMARY TB • Primary overt TB (5% infected) - single lesion or milliary TB (no immunity yet – still developing) • Post-primary/secondary TB - endogenous reactivation accompanied by a single (cavitary) lesion (strong cellular immunity) Hematogenous spread = miliary tuberculosis = secondary lesions at almost any anatomical location; may occur in a primary or secondary tuberculosis Reactivation is associated with deterioration of the cell-mediated immune response Tuberculosis may affect any tissue, any organ, any system Most common disseminated disease: kidneys, bones, spleen, meninges Exposure to TB Hypersensitivity Primary infection Immunosupression age under 5 y.o. 5% 95% Primary progressiveTB Latent TB 5% 90% Reactivation No disease Pulmonary Extra-pulmonary Dissemination Diagnosis • Tuberculin skin test with PPD (purified protein derivate) intradermal injection • Measurement of skin lesion after 48-72 hours (delayed hypersensitivity) • <5 mm induration (bump) = negative • >5 mm induration = TB infection in people who are in a high-risk group (HIV infection) • ca. 10 mm induration = TB infection in people who are in a moderate-risk group • >15 mm induration = TB infection in people who are in low-risk group Diagnosis Interferon gamma – release assay (IGRA) BCG (Bacilli Calmet-Gengou) vaccine contains viable, attenuated M. bovis Does not prevent tuberculosis !!!! The vaccine prevents only from dissemination of the disease (prevents hematogenous spread of tuberculosis) Multidrug resistant TB (MDR): strain resistant to two of the most powerful first-line drugs Extensively resistant TB (XDR): strain resistant to some of the most powerful drugs MOTT M. kansasii - lung disease M. scrofulaceum – cervical lymphadenitis in children M. avium-intracellulare (MAI) - disseminated disease in immunocompromissed M. mariunum - cutaneous disease Buruli ulcer - M. ulcerans • Contiguous disseminated • Clinical: small or large oedematous indurated plaque that may ulcerate late • Reservoir: uncertain (environment) • Treatment: rifampicin, streptomycin • Photographs show disseminated edematous BU that has been widely excised MOTT summary Exist saprophytically in the soil or water Infection initiate inhalation or introduction into skin abrasions Crucial difference between M. tuberculosis & 'atypical' mycobacteria: lack of transmission from patients to patients Resistant to drugs used in the treatment of tuberculosis, but sensitive to antibiotics: macrolides, tetracyclines, quinolones Antibiotic regimen may require 5 or 6 drugs Mycobacterium leprae • Leprosy (Hansen disease) • Non-cultivated (mouse sole, armadillo) • Acid-fast (Ziehl-Neelsen staining) • Aerobic; grow at 30oC • Grow intracellulary in skin histiocytes, endothelial cells, nerves - Schwann cells) • Endemic: Asia, Pacific region, Americas, North Africa, China • Transmission: direct contact, air-borne route Actinomyces israelii • GP, anaerobic • Colonize upper respiratory tract, gastrointestinal tract, female genital tract • Low virulence potential –– natural barriers disruption (trauma, surgery, infection) Actinomyces infections: ENDOGENOUS (polymicrobic, endodontic, odontogenic) Three types of actinomycosis • Cervicofacial • Thoracic/pulmonary • Abdominopelvic / genital Rarely: • Cerebral Actinomycosis Sulfur granule characteristic granules consisting of bacterial colony (dense rosettes of filamentous bacteria) Nocardia asteroides • Strict aerobes • Branched filaments • Virulence factors: mycolic acids (cord factor) = replicate inside macrophages, catalase, superoxide dismutase • Ubiquitous in soil rich with organic matter • Worldwide distributed, but most common in tropical/subtropical Transmission: • Inhalation (person-to-person) • Direct introduction into tissues Nocardia asteroides • Inhalation=pulmonary / bronchopulmonary nocardiosis (bronchitis, pneumonia, lung abscesses) • Traumatic introduction = cutaneous nocardiosis - Mycetoma (Madura foot) - Lymphocutaneous infections - Chronic ulcerative lesions - Subcutaneous abscesses - Cellulitis Secondary infections: meningitis, brain abscesses Mycetoma .
Load more

Recommended publications
  • Leprae by Means of Cytoplasmic Antigens
    Bull. Org. mond. Santt 1972, 46, 509-513 Bull. Wld Hlth Org. Immunological determination of Mycobacterium leprae by means of cytoplasmic antigens J. B. G. KWAPINSKI,1 J. 0. DE ALMEIDA,2 & E. H. KWAPINSKI 3 Mycobacterium leprae was isolated and purified from lepromas, the spleen, and the liver of leprosy patients. An immunodiffusion analysis of the cytoplasms obtained from four lots of M. leprae and M. lepraemurium, 295 strains of different actinomycetales, and 12 other bacteria was performed with the use ofthe cytoplasm antisera. Immunological relationships were revealed between the cytoplasms of M. leprae, M. lepraemurium, M. avium, M. gallinarum, M. tuberculosis, M. simiae, M. kansasii, M. chitae, M. cap- sulatum, Actinomyces israelii, A. naeslundii, and some strains of saprophytic myco- bacteria. These studies led to the proposed concept of the immunological evolution of M. leprae and M. lepraemurium and an Actinomyces-like progenitor through M. avium- M. gallinarum and to a proposal for the polyvalent vaccine currently being developed by this research group. Most of the past immunological research on lep- help to elucidate the immunogenicity of M. leprae rosy dealt with the skin or serum reactions of leprosy and would be useful for the preparation of an anti- patients with different mycobacterial antigen prepa- leprosy vaccine. rations. Almost all of these data were critically re- viewed by Bechelli (1971) and by de Almeida.4 More recently, the cross-reactions given by polysaccharide- MATERIALS AND METHODS protein complexes purified from M. leprae with the Sources of M. leprae and M. lepraemurium sera obtained from human leprosy, tuberculosis, and nocardiosis were revealed by Estrada-Parra (1970).
    [Show full text]
  • A Case of Disseminated Infection Due to Actinomyces Meyeri Involving
    Case Report Infection & http://dx.doi.org/10.3947/ic.2014.46.4.269 Infect Chemother 2014;46(4):269-273 Chemotherapy ISSN 2093-2340 (Print) · ISSN 2092-6448 (Online) A Case of Disseminated Infection due to Actinomyces meyeri Involving Lung and Brain Hyun Jung Park1, Ki-Ho Park3, Sung-Han Kim1, Heungsup Sung2, Sang-Ho Choi1, Yang Soo Kim1, Jun Hee Woo1, and Sang-Oh Lee1 Departments of 1Internal Medicine and 2Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul; 3Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea Actinomyces meyeri is rarely isolated in cases of actinomycosis. The identification of A. meyeri had historically been difficult and unreliable. With the recent development of 16S ribosomal RNA (16S rRNA) sequencing, Actinomyces species such as A. meyeri can be isolated much more reliably. A. meyeri often causes disseminated disease, which can be secondary to frequent pulmonary infections. A penicillin-based regimen is the mainstay of A. meyeri treatment, with a prolonged course usually re- quired. Here, we report a case of pulmonary actinomycosis with brain abscess caused by A. meyeri that was initially thought to represent lung cancer with brain metastasis. Key Words: Actinomyces; Sequence analysis, RNA; Brain abscess Introduction cies to cause similar clinical disease is largely unknown [2]. Recent developments in microbiological identification tech- Actinomycosis is a chronic infection caused by organisms in niques, especially 16S ribosomal RNA (16S rRNA) sequencing, the genus Actinomyces, with Actinomyces israelii being the have identified other Actinomyces species such as A. meyeri, most common etiologic agent [1].
    [Show full text]
  • Common Commensals
    Common Commensals Actinobacterium meyeri Aerococcus urinaeequi Arthrobacter nicotinovorans Actinomyces Aerococcus urinaehominis Arthrobacter nitroguajacolicus Actinomyces bernardiae Aerococcus viridans Arthrobacter oryzae Actinomyces bovis Alpha‐hemolytic Streptococcus, not S pneumoniae Arthrobacter oxydans Actinomyces cardiffensis Arachnia propionica Arthrobacter pascens Actinomyces dentalis Arcanobacterium Arthrobacter polychromogenes Actinomyces dentocariosus Arcanobacterium bernardiae Arthrobacter protophormiae Actinomyces DO8 Arcanobacterium haemolyticum Arthrobacter psychrolactophilus Actinomyces europaeus Arcanobacterium pluranimalium Arthrobacter psychrophenolicus Actinomyces funkei Arcanobacterium pyogenes Arthrobacter ramosus Actinomyces georgiae Arthrobacter Arthrobacter rhombi Actinomyces gerencseriae Arthrobacter agilis Arthrobacter roseus Actinomyces gerenseriae Arthrobacter albus Arthrobacter russicus Actinomyces graevenitzii Arthrobacter arilaitensis Arthrobacter scleromae Actinomyces hongkongensis Arthrobacter astrocyaneus Arthrobacter sulfonivorans Actinomyces israelii Arthrobacter atrocyaneus Arthrobacter sulfureus Actinomyces israelii serotype II Arthrobacter aurescens Arthrobacter uratoxydans Actinomyces meyeri Arthrobacter bergerei Arthrobacter ureafaciens Actinomyces naeslundii Arthrobacter chlorophenolicus Arthrobacter variabilis Actinomyces nasicola Arthrobacter citreus Arthrobacter viscosus Actinomyces neuii Arthrobacter creatinolyticus Arthrobacter woluwensis Actinomyces odontolyticus Arthrobacter crystallopoietes
    [Show full text]
  • INTERNATIONAL BULLETIN of BACTERIOLOGICAL NOMENCLATURE and TAXONOMY Vol
    INTERNATIONAL BULLETIN OF BACTERIOLOGICAL NOMENCLATURE AND TAXONOMY Vol. 15, No. 3 July 15, 1965 pp. 143-163 THE CLASSIFICATION AND PHYLOGENETIC RELATIONSHIPS OF THE ACTINOMYCETALES ' Leo Pine and Lucille Georg Communicable Disease Center, Public Health Service, U. S. Department of Health, Education, and Welfare, Atlanta, Georgia SUMMARY. The taxonomic and phylogenetic re- lationships of members of the order Actino- mycetales have been examined. On the basis of cellular and colony morphology, cell wall composition, fermentation products, and cer- tain physiological characteristics, the taxa within the family Actinomycetaceae were divided into two groups. Each group was closely related to members of the family -Lactobacillaceae. One group consisted of Actinomyces israelii, -A. naeslundii, ,A. pro- pionicus, Nocardia dentocariosus and Odonto- myces viscosis ("hamster organism"). The second group consisted of bovis, ,A. erik- sonii, and Lactobacillus bifidusA. type 11 (k parabifidus). This latter organism was re- named Actinomyces pa.rabifidus nov. comb. because its morphological, physiological and biochemical characteristics related it to the members of both groups of the genus Actino- myces. The families Streptomycetaceae and Mycobacteriaceae appeared more closely re- lated to the family Corynebacteriaceae than to the family Actinomycetaceae. The use of certain criteria for classification and deter- mination of phylogenetic relationships was discussed. We have stressed those areas in which necessasy information is lacking. A report to
    [Show full text]
  • Actinomycetes (Branching Bacteria ): Dr.Jawad K
    College of Medicine Microbiology Medical bacteriology Actinomycetes (branching bacteria ): Dr.Jawad K. Al-Khafaji ----------------------------------------------------------------------------------------- Actinomycete (fungus-like bacteria) resembles fungus as it forms mycelia and resemble bacteria as it has not true nucleus. Important properties: 1. Actinomycetes for many years were classified as fungi because the actinomycetes are form long branching filaments that resemble the hyphae of fungi .But they are reclassified as bacteria since they are thin, possesses cell wall containing muramic acid, it has prokaryotic nuclei and susceptible to bacterial antibiotic agents. 2. Actinomycetes are common in soil .There are two medically important organisms, Actinomyces israelii and Nocardia asteroids . A.israelii is anaerobe that forms part of normal flora of oral cavity. N.asteroides is aerobe and is found in environment, particularly in the soil. 3. They are gram-positive bacilli. Many isolates of N.asteroides are weakly acid fast stain. 4. The A israelii is strict anaerobic; whereas N.asteroides is grow under strict aerobic conditions. Transmission : A.israelii infection is acquired endogenously, from normal oral flora. There is no person to person spread. Infection of N.asteroides is acquired from soil by airborne route. Actinomycetes infections are not transmitted from person to person ( the diseases are not communicable ). Pathogenesis : Actinomycetes are responsible for three human infections. 1. Actinomycosis is caused by A.israelii in human or by A.bovis in cattle. The disease is chronic suppurative and granulomatous infection that produces pyogenic lesions with interconnecting sinus tract that contain sulfur granules. Three forms are (i)Cervicofacial lesion is most common ,especially among poor dental hygiene and tooth extraction.
    [Show full text]
  • ABSA General Microbiology Fact Sheets
    GENERAL MICROBIOLOGY FACT SHEET Signs & Pathogen Genus species Disease Risk Group Host Range Transmission Symptoms Incubation Fact Micrograph Bacteria Actinomcyces spp. Actinomycosis Humans, cattle, Person-to-person by contact of Opportunistic pathogen. Chronic bacterial variable - days to months. Fatality rate of 5-20% if untreated. Opportuinistic Actinomyces israelii horses mouth, aerosols, fomites. disease localized in jaw, thorax, or pathogen. abdomen. Characterized by persistent swelling, suppuration and formation of 2 abscesses or granulomas. Bacteria Bacillus cereus Food Poisoning Humans Ingestion of foods kept at Opportunistic pathogen; intoxication 1-6 hours, average 4 hours; Infectious dose is greater than 10e6 organisms by ambient conditions after characterized by two forms: an emetic form diarrheal form 6-24 hours ingestion (>10e5 organisms/g of food). cooking; emetic form frequently with severe nausea and vomiting and a (average 17 hours) associated with cooked rice. diarrheal form with abdominal cramps and 2 Not communicable from person diarrhea. Usually mild and self-limiting (24 to person. hrs). Bacteria Bordetella pertussis Whooping Cough Humans Direct contact with discharges Stage 1: Catarrhal: Irritating cough, lasts 1 6-20 days Common in children worldwide; pertussis is among the from respiratory mucous to 2 weeks; Stage 2: Paroxysmal; violent most lethal infant diseases- membranes of infected persons coughs followed by a high pitched Treatment with dTaP(acellular pertussis vaccine, a by the airborne route. inspiratory whoop, lasts 2 to 6 weeks; preventive vaccine) is now available for adults 2 Stage 3: Convalescent; the cough gradually decreases in frequency and severity, lasts several weeks Bacteria Brucella melitensis Brucellosis Humans, swine, Skin or mucous membrane High and protracted (extended) fever.
    [Show full text]
  • Actinomyces Species: Clinical Aspects and Diagnostic Possibilities
    © by author ESCMID Online Lecture Library Actinomyces species: Clinical aspects and diagnostic possibilities © by author Willem Manson ESCMID Online Lecture Library Prof. dr. John Degener, dr. Willem Manson University Medical Center Groningen UMCG AIM OF THIS PRESENTATION, to gain knowledge of: • the clinical importance of Actinomyces spp. • Clinical pitfalls. • Basic bacteriological properties of Actinomyces spp. • Methods of isolation and identification. • Recent taxonomic changes. • Antimicrobial susceptibility and therapeutc options. © by author ESCMID Online Lecture Library • A 41 year old man complains since some weeks of fever, malaise and weight loss • Since 2 days pain in the left chest • Moderately ill, dyspnea • Temp 38 C, • Friction rub. • BSE 67 mm L 15.5 • X –thorax: infiltrate left • CTscan: diminished© perfusionby author • DIAGNOSIS: lung embolism ESCMID Online Lecture Library • Intravenous heparin was administered and after 10 days the patient was discharged • Symptoms of malaise, weight loss and periods of fever persisted • BSE 127 mm, L 19.0, T 37.5 • Sputum cultures didn’t reveal any pathogenic microorganism. ZN negative • Gram stain pleural fluid: L+++, no micro-organisms, culture neg • No diagnosis was© made by and author the patient was discharged again ESCMID Online Lecture Library • Clinical condition deteriorated and 15 weeks after the first admission the patient was admitted for the third time. • Because of a suspicion of a malignancy a thoracotomy was performed. • PATHOLOGY: a inflammatory infiltrate neutrophils. Clusters of branched bacteria. No malignacy • Microbiology: Gram© Lby +++, author sporadic branched Gram positive rods ESCMID Online Lecture Library • Culture: Actinomyces species Treatment with i.v.penicillin G for 2 months followed by oral doxycyclin for 6 months At follow-up 12 months after starting therapy the patient was in a good condition without pulmonary complaints.
    [Show full text]
  • Appendix a Bacteria
    Appendix A Complete list of 594 pathogens identified in canines categorized by the following taxonomical groups: bacteria, ectoparasites, fungi, helminths, protozoa, rickettsia and viruses. Pathogens categorized as zoonotic/sapronotic/anthroponotic have been bolded; sapronoses are specifically denoted by a ❖. If the dog is involved in transmission, maintenance or detection of the pathogen it has been further underlined. Of these, if the pathogen is reported in dogs in Canada (Tier 1) it has been denoted by an *. If the pathogen is reported in Canada but canine-specific reports are lacking (Tier 2) it is marked with a C (see also Appendix C). Finally, if the pathogen has the potential to occur in Canada (Tier 3) it is marked by a D (see also Appendix D). Bacteria Brachyspira canis Enterococcus casseliflavus Acholeplasma laidlawii Brachyspira intermedia Enterococcus faecalis C Acinetobacter baumannii Brachyspira pilosicoli C Enterococcus faecium* Actinobacillus Brachyspira pulli Enterococcus gallinarum C C Brevibacterium spp. Enterococcus hirae actinomycetemcomitans D Actinobacillus lignieresii Brucella abortus Enterococcus malodoratus Actinomyces bovis Brucella canis* Enterococcus spp.* Actinomyces bowdenii Brucella suis Erysipelothrix rhusiopathiae C Actinomyces canis Burkholderia mallei Erysipelothrix tonsillarum Actinomyces catuli Burkholderia pseudomallei❖ serovar 7 Actinomyces coleocanis Campylobacter coli* Escherichia coli (EHEC, EPEC, Actinomyces hordeovulneris Campylobacter gracilis AIEC, UPEC, NTEC, Actinomyces hyovaginalis Campylobacter
    [Show full text]
  • Presentation of Pulmonary Tuberculosis and Actinomyces Co-Infection As a Lung Mass: a Literature Review and Unique Case Report
    Monaldi Archives for Chest Disease 2019; volume 89:1180 Presentation of pulmonary tuberculosis and actinomyces co-infection as a lung mass: a literature review and unique case report Evangelos Balis1, Sotirios Kakavas1, Steven Kompogiorgas1, Konstantinos Kotsifas1, Georgios Boulbasakos1 First Pulmonary Department, Evangelismos General Hospital of Athens, Greece or metastatic lung cancer and in some cases, infection and cancer Abstract may even coexist. Actinomycosis occurs in humans worldwide and is usually caused by Actinomyces israelii, an anaerobic or Parenchymal lung infections occasionally present with clinical microaerophilic, non-spore-forming, gram-positive rod. The symptoms and radiological findings similar to lung malignancy. extension of the infection in large bronchi is a rare manifestation Pulmonary actinomycosis is a rare condition of its own right, let of the disease. Most infections with Actinomyces spp. are alone in coexistence with tuberculosis. We report a case of a man polymicrobial [1]. However, cases with concomitant actinomycosis presenting with hemoptysis alongside a chest computed and tuberculosis appear to be rare. We present a case of a tomography compatible with lung cancer. The diagnosis, after Mycobacterium tuberculosis co-infection with actinomycosis that removal of a large endobronchial mass with flexible bronchoscopy presented as a large endobronchial mass. Written consent was and cryon, was a concomitant infection with Mycobacterium obtained from the patient whose personal data were fully tuberculosis and Actinomyces odontoliticus. In the literature, there anonymized to protect theonly identity of the individual. This meets the are few reported cases with concomitant tuberculosis and requirements by the Ethics Committee of Evaggelismos General actinomycosis. To our knowledge, such radical treatment without Hospital that approved the present case report.
    [Show full text]
  • Actinomyces) Propionica
    Br J Ophthalmol: first published as 10.1136/bjo.65.1.10 on 1 January 1981. Downloaded from British Journal of Ophthalmology, 1981, 65, 10-13 Lacrimal canaliculitis due to Arachnia (Actinomyces) propionica D. V. SEAL,1 J. McGILL,2 D. FLANAGAN,2 AND B. PURRIER' From the 'Public Health Laboratory, Southampton, and 2Southampton Eye Hospital SUMMARY The clinical and microbiological findings in a chronic case of lacrimal canaliculitis due to Arachnia propionica are described. Bacterial culture and identification should be performed in the investigation of the disease in order to establish the role of A. propionica and other specific actinomycetes at the acute as well as at the chronic stage. Mycotic canaliculitis has been recognised for many mal duct. A culture of the discharge grew Haemo- years as an uncommon clinical entity which usually philus influenzae, sensitive to gentamicin, while responds to surgery and iodine. 146 cases have been actinomycetes could be neither seen on examination reported from 1854 to 1972, in which a single of pus nor cultured from it. The patient was started canaliculus has usually been involved, the lower in on topical gentamicin and Polyfax (polymyxin B 105 cases and the upper in 41.1 The disease has been and bacitracin). considered in the past as due to streptothrix, The swelling and discharge persisted. After 2 leptothrix, or nocardia organisms but is now thought months the left upper punctum and canaliculus to be due to anaerobic actinomycetes, though the were explored under general anaesthesia. White species involved has not often been identified.23 cheesy material was removed from the canaliculus, Actinomyces propionicus was first isolated from a leaving a cavity 2X 2 mm wide.
    [Show full text]
  • Prosthetic Joint Infection Due to Actinomyces Species: a Case Series and Review of Literature Ramez Dagher1, Talha Riaz1, Aaron J
    J. Bone Joint Infect. 2019, Vol. 4 174 Ivyspring International Publisher Journal of Bone and Joint Infection 2019; 4(4): 174-180. doi: 10.7150/jbji.35592 Research Paper Prosthetic Joint Infection due to Actinomyces species: A case series and review of literature Ramez Dagher1, Talha Riaz1, Aaron J. Tande1, Douglas R. Osmon1, Anil Jagtiani1, James M. Steckelberg1, Tad Mabry2, Elie F. Berbari1 1. Department of Internal Medicine and Division of Infectious Diseases, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905. 2. Department of Orthopedic Surgery, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905. Corresponding author: Elie J. Berbari MD, Division of Infectious Diseases, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905. Email: [email protected], Phone: 507-255-6482, Fax: 507-255-7767 © The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions. Received: 2019.04.09; Accepted: 2019.06.07; Published: 2019.08.02 Abstract Background: Actinomyces prosthetic joint infections (APJIs) are rare and optimal medical and surgical treatment strategies are unknown. The purpose of our study was to characterize the demographics, risk factors, management and outcomes of patients with PJIs due to Actinomyces spp. Methods: Using a retrospective cohort study design, the medical records of all patients with Actinomyces spp. total hip or knee arthroplasty infection (APJI) seen at a single institution between January 1, 1969 and December 31, 2016 were reviewed.
    [Show full text]
  • Prosthetic Joint Infection Diagnosis Using Conventional Methods
    11/5/2018 Prosthetic Joint Infection Diagnosis Using Conventional Methods HOT TOPIC / 2018 ©MFMER Presenter: Robin Patel, M.D. Professor of Medicine and Microbiology Chair, Division of Clinical Microbiology and the Elizabeth P. and Robert E. Allen Professor of Individualized Medicine Department of Laboratory Medicine and Pathology at Mayo Clinic, Rochester, Minnesota ©MFMER 1 11/5/2018 Disclosures • Dr. Robin Patel has a US patent for a method and an apparatus for sonication, but has foregone her right to personally receive royalties. Funding • National Institutes of Health • Department of Defense • National Science Foundation ©MFMER Total Hip and Knee Replacement Procedures United States1 Total knee Total hip Year ©MFMER 2 11/5/2018 ©MFMER Prosthetic Hip and Knee Infections: United States2 2001‐2020 ©MFMER 3 11/5/2018 Surgical Management of Prosthetic Hip or Knee Infection3 Reprinted with permission from Massachusetts Medical Society. ©MFMER Prosthetic Joint Infection Microbiology4 Hip and Knee Hip Knee Shoulder Elbow All time periods Early Number of joints 2435 637 1979 1427 199 110 Staphylococcus aureus 27 38 13 23 18 42 Coagulase negative staphylococci 27 22 30 23 41 41 Streptococcus species 846644 Enterococcus species 310223 0 Aerobic gram negative bacilli 92475107 Anaerobic bacteria 4395 Cutibacterium acnes 24 1 Other anaerobes 30 Culture negative 14 10 7 11 15 5 Polymicrobial 15 31 14 12 16 3 Other 3 ©MFMER 4 11/5/2018 Unusual Causes of Prosthetic Joint Infection5 Actinomyces israelii Granulicatella adiacens Aspergillus fumigatus
    [Show full text]