1. Actinomyces & Nocardia

2. Actinomyces
A.israelii, A.naeslundii;
Gram positive; sulfur granule;
Related to decay tooth and peridentitis

3. ACTINOMYCES Anaerobic, filamentous, gram positive bacillus
Exhibit true branching
“Mykes” – Greek for “fungus”
Thought by early microbiologist to be fungi because of:
Morphology
Disease they cause

4. Clinical specimens:Actinomycosis-pus

5. Actinomycosis

6. Not highly virulent (Opportunist)
ACTINOMYCOSIS
Not highly virulent (Opportunist)
Component of Oral Flora
Periodontal pockets
Dental plaque
Tonsilar crypts
Take advantage of injury to penetrate mucosal barriers
Coincident infection
Trauma
Surgery

7. Actinomycosis
A chronic suppurative and granulomatous肉芽肿disease of the cervico-facial, thoracic or abdominal areas

8. ACTINOMYCOSIS
Form indurated masses with fibrous walls and central loculations with pus
Pus contains "Sulfur Granules"
Gritty, yellow white
Average diameter - 2mm
Composed of mineralized “mycelial” mass
Chronic infection
Form burrowing sinus tracts to skin or mucus membranes
Discharge purulent material

9. Actinomycosis - sulfur granule

10. Pulmonary Actinomycosis
15% of cases
Aspiration of organism from the oropaharynx
Slowly progressive process involving lung and pleura
May be mistaken for malignancy
Chest pain, fever, wgt loss and hemoptysis

11. Mycetoma (足菌病）
Streptomyces species?

12. Nocardiosis
Subcutaneous infections, pulmonary infections, and brain abscesses
N. asteroides; N. brasiliensis

15. Lab. Diagnosis
Clinical Specimens:Sputum,Pus,Biopsy tissue

16. Sulfamethoxazole-Trimethoprim