Actinomycosis is a granulomatous disease that progresses slowly and can occur in both immunocompromised and immunocompetent people and has severe complications. This infection is endogenous, and its causative agents - actinomycetes - are part of the resident microbiota of the oral cavity, gastrointestinal and urogenital tracts [1].
The purpose of the study: to summarize the clinical symptoms and diagnostic criteria of actinomycosis infection of the neck and face, which will help dentists to diagnose correctly and prescribe adequate treatment.
Materials and methods. Analysis of modern studies of scientists from different countries, including scientific articles and clinical cases (Internet resources, Medscape/PubMed databases) was carried out.
Actinomycetes are Gram-positive thin, straight or slightly curved rods that can form true mycelium. In smears from clinical material, they are located singly, in pairs or in the form of a palisade [2]. Cervical-facial actinomycosis occurs in 50-60% of cases [3]. In the oral cavity actinomycetes penetrate deep into tissues through inflamed gums near the third molar or destroyed tooth roots, pathological gum pockets in periodontitis [4].
The infection penetrates into different areas of the oral cavity: lower jaw, cheek, parotid gland, tongue, nasal cavity, pharynx, and gums. The disease progresses slowly, develops into multiple abscesses with fistulas on the surface of the skin or mucous membrane of the oral cavity painlessly, sometimes with a typical thick yellow exudate. Acute purulent forms are common less. If there is no treatment, pain and trismus associated with infiltration of the masticatory muscles may occur in the later stages of the disease [4]. A characteristic feature of the disease is the tendency to spread regardless of anatomical barriers and the development of multiple fistula tracts [5].
Actinomycosis of the salivary glands is observed when infectious agents enter the ducts. It can occur if salivary stone disease, injury, or it can spread by lymphogenous, hematogenous, and contact routes. It is manifested by a limited or spilled dense node, which is soldered to the surrounding tissues [6].
Actinomycosis often mimics malignant neoplasms, tuberculosis, fungal infections, and chronic granulomatous processes. Actinomycosis is also associated with large abscesses and/or osteomyelitis of the mandible. This disease was diagnosed in cases of periapical lesions, odontogenic cysts, peri-implantitis, osteomyelitis, etc. [7].
Laboratory diagnosis of actinomycosis includes histological, pathomorphological biopsy, bacteriological and molecular genetic studies [8-10].
The standard treatment for actinomycosis involves surgical intervention, drainage and high-dose antibiotic therapy (empiric penicillin regimen as the first-line approach). Treatment usually takes about 4 to 12 weeks [5, 11].
Conclusions. In modern medical practice, actinomycosis is a rather rare infectious disease and remains a diagnostic problem due to nonspecific symptoms that mimic other infections and malignant tumors. Laboratory diagnostic methods are of particular importance for timely confirmation of the diagnosis and treatment in order to prevent possible complications.
Reference
1. Yadegarynia D., Merza M., Sali S., Firuzkuhi A. A rare case presentation of oral actinomycosis. Int. J. Mycobac. 2013. № 2. P.187-189. DOI: 10.1016/j.ijmyco.2013.06.002.
2. Savoca E., Mehra S, Waldman E.H. A case of pediatric cervicofacial actinomyces masquerading as malignancy: Case report and review of the literature. Int. J. Pediatr. Otorhinolaryngol. 2019. № 116. P. 204-208. DOI: 10.1016/j.ijporl.2018.11.001.
3. Gajdacs M., Urban E. The Pathogenic Role of Actinomyces spp. and Related Organisms in Genitourinary Infections: Discoveries in the New, Modern Diagnostic Era. Antibiotics (Basel) .2020. V.9(8). P.524. DOI: 10.3390/antibiotics9080524.
4. Valour F., Senechal A. Actinomycosis: Etiology, clinical features, diagnosis, treatment, and management. Infect. Drug Resist. 2014. № 7. P. 183-197.
5. Moturi K., Kaila V. Cervicofacial Actinomycosis and its Management. Ann. Maxillofac. Surg. 2018. V. 8(2). P. 361-364. DOI: 10.4103/ams.ams_176_18.
6. Varshney B., Sharma V., Bharti J.N., Patro S.K. Submandibular gland actinomycosis: A rare disease - Worth to mention. J. Oral. Maxillofac. Pathol. 2019. V. 23(3). P. 479. DOI: 10.4103/jomfp.JOMFP_130_19.
7. Pasupathy S.P., Chakravarthy D., Chanmougananda S., Nair P.P. Periapical actinomycosis. BMJ Case Rep. 2012. bcr2012006218. DOI: 10.1136/bcr-2012-006218.
8. Tunney M.M., Klem E.R., Fodor A.A.…& Wolfgang M.C. Use of culture and molecular analysis to determine the effect of antibiotic treatment on microbial community diversity and abundance during exacerbation in patients with cystic fibrosis. Thorax. 2011. № 66. P. 579–584.
9. Sama C.B., Mbarga N.F., Oben C.E., Mbarga J.A., Nfor E.K., Angwafo Iii.F.F. Massive paediatric cervicofacial actinomycoses masquerading as an ulcerative malignancy. BMC Infect. Dis. 2016. V. 16(1). P. 417. DOI: 10.1186/s12879-016-1768-8.
10. Yilin Z., Xinyi L., Longwei S., Hongwu Z. Pediatric pulmonary actinomycosis: A misdiagnosed case report. Front. Pediatr. 2022. № 10:955554. DOI: 10.3389/fped.2022.955554.
11.Stabrowsky T., Chuard C. Actinomycosis. Rev. Med. Suisse. 2019. V. 15(666). 1790-1794.
|
Голосування 
Ця робота ліцензується відповідно до Creative Commons Attribution 4.0 International License
Знайшли помилку? Виділіть помилковий текст мишкою і натисніть Ctrl + Enter