Actinomycosis: difficulties in diagnosis and features of treatment

Actinomycosis is caused by a special radiant fungus that can affect both the skin and internal organs, and without proper treatment, such a lesion can lead to death. It is possible to diagnose skin lesions with actinomycetes only on the basis of bacteriological culture from the discharge during actinomycosis, this helps to detect characteristic colonies and particles of mycelium of the fungus. The treatment of actinomycosis must be thorough and lengthy, individually selected, because if the doctor's recommendations are not followed, the disease recurs.

 Why actinomycosis occurs and how the disease manifests itself

The causative agent of actinomycosis is widely distributed in nature, including it is often found as a saprophytic flora on the mucous membranes of the human body. Actinomycetes cannot be transmitted to humans from sick animals or from a sick person to a healthy one. They enter the body through small wounds on the skin, by inhalation, and even with food – often after walking in the forest, in the field, in the countryside, lying on the grass, in the hay. Actinomycosis of the skin develops after penetration through lesions on the skin or as a secondary infection – during its transition from inflamed tonsils, gums, lymph nodes. Actinomycosis of internal organs can develop if the pathogen got inside the body and became active against the background of food poisoning, inflammation of the gastrointestinal tract, and other internal organs.

Actinomycosis can disturb the patient for many years, and against the background of the absence of external manifestations, damage to internal organs may develop. In the cutaneous form of actinomycosis, the disease most often manifests itself in the area under the jaw, on the buttocks and back above the sacral zone. Skin lesions appear as bluish-purple spots, under  which have spherical seals. At first, these formations are very dense, although not painful, then they become softer and burst, and fistulas form in their place. Fistulas do not heal well, fester, and in the discharge you can see blood impurities and yellow grains – fungal drusen, becoming a good diagnostic indicator.

With the cervico-maxillary form of actinomycosis, the process can move to the face, capture lips, tongue and even eyes, penetrate into the larynx and trachea. There are four types of skin lesions in actinomycosis:

• atheromas (most often in children);
• tubercles turning into pustules and fistulas;
• nodules resembling cartilage in density;
• ulcerative form and tissue necrosis.

 Peculiarities of diagnosis of actinomycosis and treatment specifics

It is quite difficult to diagnose actinomycosis correctly. If you take a swab from the throat or nose, then actinomycetes will be found in most healthy people. You can do percutaneous  puncture and try to detect fungal drusen in the fistula discharge, but in 75% of cases they are not there. The culture of biopsy material gives the most accurate diagnostic answer, but a reliable study of such a culture takes about 2 weeks, although after 2-3 days characteristic actinomycete colonies are visible under a microscope. Methods for PCR diagnostics and serological diagnostics of this disease are still imperfect.

Treatment is carried out by the introduction of actinolysate – under the skin and intramuscularly. Recommended antibiotic therapy, taking general tonic. A good therapeutic effect is the use of electrophoresis with iodine and actinolysate on the affected area.

The disease often recurs, but there is no specific prevention. Patients are recommended timely treatment of inflammatory diseases of the oral cavity (teeth, gums, tonsils), hygiene.