Actinomycosis

Actinomycosis is a sub-acute to chronic bacterial infection, which can be caused by filamentous, gram-positive, non-acid-fast, and anaerobic to microaerophilic bacteria.  The sinus tract can be infected with multiple abscesses’, which may cause sulfur granule discharge.  It can be characterized by contiguous spread, supportive and granulomatous inflammation.  Cervicofacial, thoracic and abdominal are the most common clinical forms of actinomycosis.  However, in women pelvic actinomycosis can occur.

Cervicofacial actinomycosis is the most common type of infection.  This type of actinomycosis can occur in dental patients who have poor dental hygiene or have had oral surgery. 

Thoracic actinomycosis commonly appears as pulmonary infiltrate or mass, this type of actinomycosis accounts for 15-20% of cases.
Actinomycosis of the abdomen and pelvis can occur, although less likely, this type of infection accounts for 10-20%of cases.  Most patients that have actinomycosis of the abdomen and pelvis have had recent or remote bowel surgery or ingestion of foreign bodies. Typically this disease starts as a slow growing tumor.

Actinomycosis is a rare disease.  Proper dental hygiene and use of antibiotics have contributed to the declining spread of this disease. 

Hyperbaric oxygen therapy can be used to treat actinomycosis by increasing oxygen tension with subsequent oxygen radical formation which often proves lethal for most anaerobic organisms.