Actinomyces &

Nocardia
 Actinomyces

 A.israelii,
A.naeslundii;
 Gram positive;
sulfur granule;
 Related to decay
tooth and
peridentitis
 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
Clinical specimens:Actinomycosis-pus
 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
 Actinomycosis
 A chronic suppurative and granulomatous 肉
芽肿 disease of the cervico-facial, thoracic or
abdominal areas
 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
Actinomycosis - sulfur granule
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
Mycetoma
( 足菌病）

Streptomyces
species?
 Nocardiosis
 Subcutaneous
infections, pulmonary
infections, and brain
abscesses
 N. asteroides; N.
brasiliensis
 Lab. Diagnosis
 Clinical
Specimens:Sputum,Pus,Biopsy tissue

Sulfamethoxazole-Trimethoprim