Re: Actinomycosis - mistaken as lyme?

July 30, 2005

Thanks Penny

Like many my current health problems were triggered by oral surgery

(infections involved) and neck trauma. I did have some pencillin 24

years ago when all this started but just two short courses at

standard doses, at that time they had no effect but a different class

of ab did.

I will be talking to my Lyme and ME/CFS literate doctor next month

and these issues were part of what I wanted to discuss with him. No

chance of a scan through our NHS, it took 24 years and persistence

just to get a funded cervical spine MRI, that explained some of my

non infections based disability.

Cheers, Tansy

> Here are 2 articles on Actinomycosis. A very destructive, bone

> eating bacteria that for many many years was thought to be a fungus

> (hence the mycosis ending). A lot of docs still mistakenly assume

> it's a fungus. A friend of mine recently, as a last resort, went to

> a cancer specialist who routinely works with head and neck cancer

> and he discovered that she was full of actino wormholing it's way

> through her sinuses and jaw. He said he sees this all the time, and

> isn't surprised, but that actino is very hard to detect or culture,

> so most docs are oblivious. And, interestingly, Actinomycosis looks

> much the same as lyme disease does on PCR testing. Acording to my

> friend, when she talked to IGenex a couple years back, they told

her

> that it would be quite possible to confuse actino with lyme

> organisms in PCR testing. Whether this still holds true, I don't

> know, but I think it would make sense to find out, especially when

> you read below how many areas Actino affects, and how difficult it

> is to treat.

>

> It's also interesting that one of Actino's forms likes the lungs

and

> that it produces a granulomatous immune response. Perhaps it's the

> cause of Sarcoidosis? It also can cause Pelvic disease in women,

> tonsil problems, can affect the brain, etc. And debridement of the

> jaw and sinuses is not, according to this cancer specialist, a good

> way to go, because you will just keep debriding until there's no

> bone left.

>

> Actino is probably most commonly introduced through dental or bone

> trauma or even tissue injury (I'm thinking how many people seem

> inexplicably stricken with CFS after a whip lash type injury).

>

> Actino apparently responds best to penicillin G, but treatment can

> last a year or more. This is what my friend is currently doing.

> Augmentin is also a drug that sometimes is beneficial.

>

> This is an organism that I think people should really be looking at

> as a possible culprit in their illnesses.

>

> penny

>

> Actinomycosis is a subacute-to-chronic bacterial infection caused

by

> filamentous, gram-positive, anaerobic-to-microaerophilic bacteria

> that are not acid fast. It is characterized by contiguous spread,

> suppurative and granulomatous inflammatory reaction, and formation

> of multiple abscesses and sinus tracts that discharge sulfur

> granules. The most common clinical forms of actinomycosis are

> cervicofacial (ie, lumpy jaw), thoracic, and abdominal. In women,

> pelvic actinomycosis is common.

>

> Pathophysiology: The actinomycetes are prominent among the normal

> flora of the oral cavity and less prominent in the lower

> gastrointestinal tract and female genital tract. As these

> microorganisms are not virulent, they require a break in the

> integrity of the mucous membranes and the presence of devitalized

> tissue to invade deeper body structures and cause human illness.

>

> Furthermore, actinomycosis generally is a polymicrobial infection,

> with isolates numbering as many as 5-10 bacterial species.

> Establishment of human infection may require the presence of such

> companion bacteria, which participate in the production of

infection

> by elaborating a toxin or enzyme or by inhibiting host defenses.

> These companion bacteria appear to act as copathogens that enhance

> the relatively low invasive power of actinomycetes. Specifically,

> they are responsible for the early manifestations of the infection

> and for treatment failures.

>

> Once infection is established, the host mounts an intense

> inflammatory (ie, suppurative, granulomatous) response, and

fibrosis

> develops subsequently. Infection typically spreads contiguously,

> frequently ignoring tissue planes and invading surrounding tissues

> or organs. Ultimately, the infection produces draining sinus

tracts.

> Hematogenous dissemination to distant organs may occur in any stage

> of the infection, whereas lymphatic dissemination is unusual.

>

> Cervicofacial actinomycosis

>

> Cervicofacial actinomycosis is the most common manifestation,

> comprising 50-70% of reported cases. Infection typically occurs

> following oral surgery or in patients with poor dental hygiene.

This

> form of actinomycosis is characterized in the initial stages by

soft-

> tissue swelling of the perimandibular area. Direct spread into the

> adjacent tissues occurs over time, along with development of

> fistulas that discharge purulent material containing yellow (ie,

> sulfur) granules. Invasion of the cranium or the bloodstream may

> occur if the disease is left untreated.

>

> Thoracic actinomycosis

>

> Thoracic actinomycosis accounts for 15-20% of cases. Aspiration of

> oropharyngeal secretions containing actinomycetes is the usual

> mechanism of infection. Occasionally, thoracic actinomycosis may

> result from the introduction of organisms via esophageal

> perforation, by direct spread from an actinomycotic process of the

> neck or abdomen, or via hematogenous spread from a distant lesion.

> Thoracic actinomycosis commonly presents as a pulmonary infiltrate

> or mass, which, if left untreated, can spread to involve the

pleura,

> pericardium, and chest wall, ultimately leading to the formation of

> sinuses that discharge sulfur granules.

>

> Actinomycosis of the abdomen and pelvis

>

> Actinomycosis of the abdomen and pelvis accounts for 10-20% of

> reported cases. Typically, patients have a history of recent or

> remote bowel surgery (eg, perforated acute appendicitis, perforated

> colonic diverticulitis following trauma to the abdomen) or

ingestion

> of foreign bodies (eg, chicken or fish bones), during which

> actinomycetes is introduced into the deep tissues. The ileocecal

> region is involved most frequently, and the disease presents

> classically as a slowly growing tumor. Involvement of any abdominal

> organ, including the abdominal wall, can occur by direct spread,

> with eventual formation of draining sinuses. Actinomycosis of the

> pelvis most commonly occurs by the ascending route from the uterus

> in association with intrauterine contraceptive devices (IUCDs). In

> such cases, an IUCD has been in place for an average of 8 years.

>

> Frequency:

>

> In the US: Actinomycosis is a rare infection. During the 1970s, the

> reported annual incidence in the Cleveland area was 1 case per

> 300,000. Improved dental hygiene and widespread use of antibiotics

> for various infections probably have contributed to the declining

> incidence of this disease.

> Internationally: Actinomycosis occurs worldwide, with likely higher

> prevalence rates in areas with low socioeconomic status and poor

> dental hygiene.

> Mortality/Morbidity: The availability of antibiotics has greatly

> improved the prognosis for all forms of actinomycosis. At present,

> cure rates are high and neither deformity nor death is common.

>

> Race: No racial predilection exists.

>

> Sex: For unknown reasons, men are affected more commonly than

women,

> with the exception of pelvic actinomycosis. The reported male-to-

> female ratio is 3:1.

>

> Age: Actinomycosis can affect people of all ages, but the majority

> of cases are reported in young to middle-aged adults (aged 20-50

y).

>

> http://www.emedicine.com/med/topic31.htm

>

> Actinomycosis

>

> Definition of Actinomycosis

> Actinomycosis is an infection caused by a bacterium called

> Actinomyces israelii (A. israelii).

>

> Description of Actinomycosis

> Actinomycosis (also known as Rivalta disease, big jaw, clams, lumpy

> jaw or wooden tongue) is an infection, commonly of the face and

> neck, that produces abscesses (collections of pus) and open-

draining

> sinuses (tracts in the skin).

>

> Actinomycosis is caused by a bacterium called Actinomyces israelii

> (A. israelii). It occurs normally in the mouth and tonsils. This

> bacterium may cause infection when it is introduced into the soft

> tissues by trauma, surgery or another infection. Once in the

> tissues, it may form an abscess that develops into a hard red to

> reddish purple lump. When the abscess breaks through the skin, it

> forms pus-discharging lesions.

>

> There are at least five (5) types of actinomycosis:

>

> Cervicofacial actinomycosis occurs in the mouth, neck and head

> region. The bacterium enters through the periodontium (the tissues

> surrounding and supporting the teeth), soft tissue wounds or

> salivary gland ducts. It is believed that infection may arise after

> a tooth extraction, from tooth decay or abscess, as a part of

> periodontal disease, from a nonpenetrating jaw trauma, poor dental

> hygiene, or mucosal injuries.

>

> Cervicofacial actinomycosis develops slowly. The area becomes hard,

> the overlying skin becomes reddish and swelling appears in the

mouth

> and neck. Abscesses develop within and eventually drain to the

> surface where sulfur granules (yellowish gray masses), masses of

> filamentous (long, threadlike structure) organisms, may be found in

> the pus.

>

> Thoracic actinomycosis involves the lungs and mediastinum (region

> between the two lungs). The disease begins with fever, cough, and

> sputum production. The patient becomes weak, loses weight and may

> have night sweats and shortness of breath. Multiple sinuses may

> extend through the chest wall, to the heart, or into the abdominal

> cavity. Ribs may be involved. Occasionally, cervicofacial and

> thoracic disease may result in nervous system complications - most

> commonly brain abscesses or meningitis.

>

> Abdominal actinomycosis are mostly preceded by surgery such as

> laparotomy for acute appendicitis, perforated ulcer, or gallbladder

> inflammation. Infection usually begins in the gastrointestinal

tract

> and spreads to the abdominal wall. Spiking fever and chills,

> intestinal colic, vomiting, and weight loss, a palpable (can be

> felt) mass and an external sinus are evident in this type of

> actinomycosis. This type of actinomycosis may be mistaken for

> Crohn's disease, malignancy, tuberculosis, Amebiasis (an infection

> of the intestine or liver), or chronic appendicitis.

>

> Pelvic actinomycosis affects the women's pelvic area and may cause

> lower abdominal pain, fever, and bleeding between menstrual

periods.

> This form of the infection has been associated with the use of IUDs

> (intra-uterine devices) that do not contain copper.

>

> Generalized actinomycosis may involve the skin, brain, liver and

> urogenital system.

>

> Diagnosis of Actinomycosis

> Actinomycosis may be hard to diagnose at onset. There are lab tests

> that may isolate actinomyces in pus or tissue specimens.

>

> Treatment of Actinomycosis

> Treatment for actinomycosis is long term, generally with up to one

> month of intravenous penicillin G, followed by weeks to months of

> penicillin taken by mouth. Additionally, surgical excision and

> drainage of abscesses may be necessary.

>

> http://www.healthscout.com/ency/68/258/main.html

July 30, 2005

Hi Penny:

How did the doc dx actino...thru scans or did he take a biopsy?

Tx,

> Here are 2 articles on Actinomycosis. A very destructive, bone

> eating bacteria that for many many years was thought to be a

fungus

> (hence the mycosis ending). A lot of docs still mistakenly assume

> it's a fungus. A friend of mine recently, as a last resort, went

to

> a cancer specialist who routinely works with head and neck cancer

> and he discovered that she was full of actino wormholing it's way

> through her sinuses and jaw. He said he sees this all the time,

and

> isn't surprised, but that actino is very hard to detect or

culture,

> so most docs are oblivious. And, interestingly, Actinomycosis

looks

> much the same as lyme disease does on PCR testing. Acording to my

> friend, when she talked to IGenex a couple years back, they told

her

> that it would be quite possible to confuse actino with lyme

> organisms in PCR testing. Whether this still holds true, I don't

> know, but I think it would make sense to find out, especially when

> you read below how many areas Actino affects, and how difficult it

> is to treat.

>

> It's also interesting that one of Actino's forms likes the lungs

and

> that it produces a granulomatous immune response. Perhaps it's the

> cause of Sarcoidosis? It also can cause Pelvic disease in women,

> tonsil problems, can affect the brain, etc. And debridement of the

> jaw and sinuses is not, according to this cancer specialist, a

good

> way to go, because you will just keep debriding until there's no

> bone left.

>

> Actino is probably most commonly introduced through dental or bone

> trauma or even tissue injury (I'm thinking how many people seem

> inexplicably stricken with CFS after a whip lash type injury).

>

> Actino apparently responds best to penicillin G, but treatment can

> last a year or more. This is what my friend is currently doing.

> Augmentin is also a drug that sometimes is beneficial.

>

> This is an organism that I think people should really be looking

at

> as a possible culprit in their illnesses.

>

> penny

>

> Actinomycosis is a subacute-to-chronic bacterial infection caused

by

> filamentous, gram-positive, anaerobic-to-microaerophilic bacteria

> that are not acid fast. It is characterized by contiguous spread,

> suppurative and granulomatous inflammatory reaction, and formation

> of multiple abscesses and sinus tracts that discharge sulfur

> granules. The most common clinical forms of actinomycosis are

> cervicofacial (ie, lumpy jaw), thoracic, and abdominal. In women,

> pelvic actinomycosis is common.

>

> Pathophysiology: The actinomycetes are prominent among the normal

> flora of the oral cavity and less prominent in the lower

> gastrointestinal tract and female genital tract. As these

> microorganisms are not virulent, they require a break in the

> integrity of the mucous membranes and the presence of devitalized

> tissue to invade deeper body structures and cause human illness.

>

> Furthermore, actinomycosis generally is a polymicrobial infection,

> with isolates numbering as many as 5-10 bacterial species.

> Establishment of human infection may require the presence of such

> companion bacteria, which participate in the production of

infection

> by elaborating a toxin or enzyme or by inhibiting host defenses.

> These companion bacteria appear to act as copathogens that enhance

> the relatively low invasive power of actinomycetes. Specifically,

> they are responsible for the early manifestations of the infection

> and for treatment failures.

>

> Once infection is established, the host mounts an intense

> inflammatory (ie, suppurative, granulomatous) response, and

fibrosis

> develops subsequently. Infection typically spreads contiguously,

> frequently ignoring tissue planes and invading surrounding tissues

> or organs. Ultimately, the infection produces draining sinus

tracts.

> Hematogenous dissemination to distant organs may occur in any

stage

> of the infection, whereas lymphatic dissemination is unusual.

>

> Cervicofacial actinomycosis

>

> Cervicofacial actinomycosis is the most common manifestation,

> comprising 50-70% of reported cases. Infection typically occurs

> following oral surgery or in patients with poor dental hygiene.

This

> form of actinomycosis is characterized in the initial stages by

soft-

> tissue swelling of the perimandibular area. Direct spread into the

> adjacent tissues occurs over time, along with development of

> fistulas that discharge purulent material containing yellow (ie,

> sulfur) granules. Invasion of the cranium or the bloodstream may

> occur if the disease is left untreated.

>

> Thoracic actinomycosis

>

> Thoracic actinomycosis accounts for 15-20% of cases. Aspiration of

> oropharyngeal secretions containing actinomycetes is the usual

> mechanism of infection. Occasionally, thoracic actinomycosis may

> result from the introduction of organisms via esophageal

> perforation, by direct spread from an actinomycotic process of the

> neck or abdomen, or via hematogenous spread from a distant lesion.

> Thoracic actinomycosis commonly presents as a pulmonary infiltrate

> or mass, which, if left untreated, can spread to involve the

pleura,

> pericardium, and chest wall, ultimately leading to the formation

of

> sinuses that discharge sulfur granules.

>

> Actinomycosis of the abdomen and pelvis

>

> Actinomycosis of the abdomen and pelvis accounts for 10-20% of

> reported cases. Typically, patients have a history of recent or

> remote bowel surgery (eg, perforated acute appendicitis,

perforated

> colonic diverticulitis following trauma to the abdomen) or

ingestion

> of foreign bodies (eg, chicken or fish bones), during which

> actinomycetes is introduced into the deep tissues. The ileocecal

> region is involved most frequently, and the disease presents

> classically as a slowly growing tumor. Involvement of any

abdominal

> organ, including the abdominal wall, can occur by direct spread,

> with eventual formation of draining sinuses. Actinomycosis of the

> pelvis most commonly occurs by the ascending route from the uterus

> in association with intrauterine contraceptive devices (IUCDs). In

> such cases, an IUCD has been in place for an average of 8 years.

>

> Frequency:

>

> In the US: Actinomycosis is a rare infection. During the 1970s,

the

> reported annual incidence in the Cleveland area was 1 case per

> 300,000. Improved dental hygiene and widespread use of antibiotics

> for various infections probably have contributed to the declining

> incidence of this disease.

> Internationally: Actinomycosis occurs worldwide, with likely

higher

> prevalence rates in areas with low socioeconomic status and poor

> dental hygiene.

> Mortality/Morbidity: The availability of antibiotics has greatly

> improved the prognosis for all forms of actinomycosis. At present,

> cure rates are high and neither deformity nor death is common.

>

> Race: No racial predilection exists.

>

> Sex: For unknown reasons, men are affected more commonly than

women,

> with the exception of pelvic actinomycosis. The reported male-to-

> female ratio is 3:1.

>

> Age: Actinomycosis can affect people of all ages, but the majority

> of cases are reported in young to middle-aged adults (aged 20-50

y).

>

> http://www.emedicine.com/med/topic31.htm

>

> Actinomycosis

>

> Definition of Actinomycosis

> Actinomycosis is an infection caused by a bacterium called

> Actinomyces israelii (A. israelii).

>

> Description of Actinomycosis

> Actinomycosis (also known as Rivalta disease, big jaw, clams,

lumpy

> jaw or wooden tongue) is an infection, commonly of the face and

> neck, that produces abscesses (collections of pus) and open-

draining

> sinuses (tracts in the skin).

>

> Actinomycosis is caused by a bacterium called Actinomyces israelii

> (A. israelii). It occurs normally in the mouth and tonsils. This

> bacterium may cause infection when it is introduced into the soft

> tissues by trauma, surgery or another infection. Once in the

> tissues, it may form an abscess that develops into a hard red to

> reddish purple lump. When the abscess breaks through the skin, it

> forms pus-discharging lesions.

>

> There are at least five (5) types of actinomycosis:

>

> Cervicofacial actinomycosis occurs in the mouth, neck and head

> region. The bacterium enters through the periodontium (the tissues

> surrounding and supporting the teeth), soft tissue wounds or

> salivary gland ducts. It is believed that infection may arise

after

> a tooth extraction, from tooth decay or abscess, as a part of

> periodontal disease, from a nonpenetrating jaw trauma, poor dental

> hygiene, or mucosal injuries.

>

> Cervicofacial actinomycosis develops slowly. The area becomes

hard,

> the overlying skin becomes reddish and swelling appears in the

mouth

> and neck. Abscesses develop within and eventually drain to the

> surface where sulfur granules (yellowish gray masses), masses of

> filamentous (long, threadlike structure) organisms, may be found

in

> the pus.

>

> Thoracic actinomycosis involves the lungs and mediastinum (region

> between the two lungs). The disease begins with fever, cough, and

> sputum production. The patient becomes weak, loses weight and may

> have night sweats and shortness of breath. Multiple sinuses may

> extend through the chest wall, to the heart, or into the abdominal

> cavity. Ribs may be involved. Occasionally, cervicofacial and

> thoracic disease may result in nervous system complications - most

> commonly brain abscesses or meningitis.

>

> Abdominal actinomycosis are mostly preceded by surgery such as

> laparotomy for acute appendicitis, perforated ulcer, or

gallbladder

> inflammation. Infection usually begins in the gastrointestinal

tract

> and spreads to the abdominal wall. Spiking fever and chills,

> intestinal colic, vomiting, and weight loss, a palpable (can be

> felt) mass and an external sinus are evident in this type of

> actinomycosis. This type of actinomycosis may be mistaken for

> Crohn's disease, malignancy, tuberculosis, Amebiasis (an infection

> of the intestine or liver), or chronic appendicitis.

>

> Pelvic actinomycosis affects the women's pelvic area and may cause

> lower abdominal pain, fever, and bleeding between menstrual

periods.

> This form of the infection has been associated with the use of

IUDs

> (intra-uterine devices) that do not contain copper.

>

> Generalized actinomycosis may involve the skin, brain, liver and

> urogenital system.

>

> Diagnosis of Actinomycosis

> Actinomycosis may be hard to diagnose at onset. There are lab

tests

> that may isolate actinomyces in pus or tissue specimens.

>

> Treatment of Actinomycosis

> Treatment for actinomycosis is long term, generally with up to one

> month of intravenous penicillin G, followed by weeks to months of

> penicillin taken by mouth. Additionally, surgical excision and

> drainage of abscesses may be necessary.

>

> http://www.healthscout.com/ency/68/258/main.html

July 30, 2005

She had very good scans which she took to the cancer specialist, who

used them to guide a miniscule camera up through her nose where he

was able to capture photos of the pus draining and recognized it

from previous experience as actinomyces. He also took samples for

culture (a time/heat sensitive situation), and put her on penicillin

G. and said it's a long term treatment. Unfortunately, the prognosis

is not so great for her because there's been so much structural

damage done already with bad debridement surgeries. He may have no

choice but to go in with a very fine instrument and gently " sweep "

the damaged areas to eradicate the dead material that blocks

effective treatment, then treat with topical and follow up abx, but

he's pretty adamant that more standard debridement is a very bad

idea. This probably explains why so many people who get treated for

Osteonecrosis or Osteomyelitis of the jaw and also people who have

their sinuses reamed out, don't get better. It's upsetting how many

people are being treated using bad scans and surgery w/o proper abx

treatment. A simple jaw scan like you get in a dental office, or

especially the controversial Cavitat scan, IMO, is not adequate or

reliable enough to make such major treatment decisions. You need

someone who really knows how to do a full scan of the sinuses and

jaw to see where infection may be feeding back and forth to know how

to treat effectively. My personal opinion is to never let an average

dentist or ENT convince you that surgery is the answer, without LOTS

of diagnostic info to support that claim.

penny

> > Here are 2 articles on Actinomycosis. A very destructive, bone

> > eating bacteria that for many many years was thought to be a

> fungus

> > (hence the mycosis ending). A lot of docs still mistakenly

assume

> > it's a fungus. A friend of mine recently, as a last resort, went

> to

> > a cancer specialist who routinely works with head and neck

cancer

> > and he discovered that she was full of actino wormholing it's

way

> > through her sinuses and jaw. He said he sees this all the time,

> and

> > isn't surprised, but that actino is very hard to detect or

> culture,

> > so most docs are oblivious. And, interestingly, Actinomycosis

> looks

> > much the same as lyme disease does on PCR testing. Acording to

my

> > friend, when she talked to IGenex a couple years back, they told

> her

> > that it would be quite possible to confuse actino with lyme

> > organisms in PCR testing. Whether this still holds true, I don't

> > know, but I think it would make sense to find out, especially

when

> > you read below how many areas Actino affects, and how difficult

it

> > is to treat.

> >

> > It's also interesting that one of Actino's forms likes the lungs

> and

> > that it produces a granulomatous immune response. Perhaps it's

the

> > cause of Sarcoidosis? It also can cause Pelvic disease in women,

> > tonsil problems, can affect the brain, etc. And debridement of

the

> > jaw and sinuses is not, according to this cancer specialist, a

> good

> > way to go, because you will just keep debriding until there's no

> > bone left.

> >

> > Actino is probably most commonly introduced through dental or

bone

> > trauma or even tissue injury (I'm thinking how many people seem

> > inexplicably stricken with CFS after a whip lash type injury).

> >

> > Actino apparently responds best to penicillin G, but treatment

can

> > last a year or more. This is what my friend is currently doing.

> > Augmentin is also a drug that sometimes is beneficial.

> >

> > This is an organism that I think people should really be looking

> at

> > as a possible culprit in their illnesses.

> >

> > penny

> >

> > Actinomycosis is a subacute-to-chronic bacterial infection

caused

> by

> > filamentous, gram-positive, anaerobic-to-microaerophilic

bacteria

> > that are not acid fast. It is characterized by contiguous

spread,

> > suppurative and granulomatous inflammatory reaction, and

formation

> > of multiple abscesses and sinus tracts that discharge sulfur

> > granules. The most common clinical forms of actinomycosis are

> > cervicofacial (ie, lumpy jaw), thoracic, and abdominal. In

women,

> > pelvic actinomycosis is common.

> >

> > Pathophysiology: The actinomycetes are prominent among the

normal

> > flora of the oral cavity and less prominent in the lower

> > gastrointestinal tract and female genital tract. As these

> > microorganisms are not virulent, they require a break in the

> > integrity of the mucous membranes and the presence of

devitalized

> > tissue to invade deeper body structures and cause human illness.

> >

> > Furthermore, actinomycosis generally is a polymicrobial

infection,

> > with isolates numbering as many as 5-10 bacterial species.

> > Establishment of human infection may require the presence of

such

> > companion bacteria, which participate in the production of

> infection

> > by elaborating a toxin or enzyme or by inhibiting host defenses.

> > These companion bacteria appear to act as copathogens that

enhance

> > the relatively low invasive power of actinomycetes.

Specifically,

> > they are responsible for the early manifestations of the

infection

> > and for treatment failures.

> >

> > Once infection is established, the host mounts an intense

> > inflammatory (ie, suppurative, granulomatous) response, and

> fibrosis

> > develops subsequently. Infection typically spreads contiguously,

> > frequently ignoring tissue planes and invading surrounding

tissues

> > or organs. Ultimately, the infection produces draining sinus

> tracts.

> > Hematogenous dissemination to distant organs may occur in any

> stage

> > of the infection, whereas lymphatic dissemination is unusual.

> >

> > Cervicofacial actinomycosis

> >

> > Cervicofacial actinomycosis is the most common manifestation,

> > comprising 50-70% of reported cases. Infection typically occurs

> > following oral surgery or in patients with poor dental hygiene.

> This

> > form of actinomycosis is characterized in the initial stages by

> soft-

> > tissue swelling of the perimandibular area. Direct spread into

the

> > adjacent tissues occurs over time, along with development of

> > fistulas that discharge purulent material containing yellow (ie,

> > sulfur) granules. Invasion of the cranium or the bloodstream may

> > occur if the disease is left untreated.

> >

> > Thoracic actinomycosis

> >

> > Thoracic actinomycosis accounts for 15-20% of cases. Aspiration

of

> > oropharyngeal secretions containing actinomycetes is the usual

> > mechanism of infection. Occasionally, thoracic actinomycosis may

> > result from the introduction of organisms via esophageal

> > perforation, by direct spread from an actinomycotic process of

the

> > neck or abdomen, or via hematogenous spread from a distant

lesion.

> > Thoracic actinomycosis commonly presents as a pulmonary

infiltrate

> > or mass, which, if left untreated, can spread to involve the

> pleura,

> > pericardium, and chest wall, ultimately leading to the formation

> of

> > sinuses that discharge sulfur granules.

> >

> > Actinomycosis of the abdomen and pelvis

> >

> > Actinomycosis of the abdomen and pelvis accounts for 10-20% of

> > reported cases. Typically, patients have a history of recent or

> > remote bowel surgery (eg, perforated acute appendicitis,

> perforated

> > colonic diverticulitis following trauma to the abdomen) or

> ingestion

> > of foreign bodies (eg, chicken or fish bones), during which

> > actinomycetes is introduced into the deep tissues. The ileocecal

> > region is involved most frequently, and the disease presents

> > classically as a slowly growing tumor. Involvement of any

> abdominal

> > organ, including the abdominal wall, can occur by direct spread,

> > with eventual formation of draining sinuses. Actinomycosis of

the

> > pelvis most commonly occurs by the ascending route from the

uterus

> > in association with intrauterine contraceptive devices (IUCDs).

In

> > such cases, an IUCD has been in place for an average of 8 years.

> >

> > Frequency:

> >

> > In the US: Actinomycosis is a rare infection. During the 1970s,

> the

> > reported annual incidence in the Cleveland area was 1 case per

> > 300,000. Improved dental hygiene and widespread use of

antibiotics

> > for various infections probably have contributed to the

declining

> > incidence of this disease.

> > Internationally: Actinomycosis occurs worldwide, with likely

> higher

> > prevalence rates in areas with low socioeconomic status and poor

> > dental hygiene.

> > Mortality/Morbidity: The availability of antibiotics has greatly

> > improved the prognosis for all forms of actinomycosis. At

present,

> > cure rates are high and neither deformity nor death is common.

> >

> > Race: No racial predilection exists.

> >

> > Sex: For unknown reasons, men are affected more commonly than

> women,

> > with the exception of pelvic actinomycosis. The reported male-to-

> > female ratio is 3:1.

> >

> > Age: Actinomycosis can affect people of all ages, but the

majority

> > of cases are reported in young to middle-aged adults (aged 20-50

> y).

> >

> > http://www.emedicine.com/med/topic31.htm

> >

> > Actinomycosis

> >

> > Definition of Actinomycosis

> > Actinomycosis is an infection caused by a bacterium called

> > Actinomyces israelii (A. israelii).

> >

> > Description of Actinomycosis

> > Actinomycosis (also known as Rivalta disease, big jaw, clams,

> lumpy

> > jaw or wooden tongue) is an infection, commonly of the face and

> > neck, that produces abscesses (collections of pus) and open-

> draining

> > sinuses (tracts in the skin).

> >

> > Actinomycosis is caused by a bacterium called Actinomyces

israelii

> > (A. israelii). It occurs normally in the mouth and tonsils. This

> > bacterium may cause infection when it is introduced into the

soft

> > tissues by trauma, surgery or another infection. Once in the

> > tissues, it may form an abscess that develops into a hard red to

> > reddish purple lump. When the abscess breaks through the skin,

it

> > forms pus-discharging lesions.

> >

> > There are at least five (5) types of actinomycosis:

> >

> > Cervicofacial actinomycosis occurs in the mouth, neck and head

> > region. The bacterium enters through the periodontium (the

tissues

> > surrounding and supporting the teeth), soft tissue wounds or

> > salivary gland ducts. It is believed that infection may arise

> after

> > a tooth extraction, from tooth decay or abscess, as a part of

> > periodontal disease, from a nonpenetrating jaw trauma, poor

dental

> > hygiene, or mucosal injuries.

> >

> > Cervicofacial actinomycosis develops slowly. The area becomes

> hard,

> > the overlying skin becomes reddish and swelling appears in the

> mouth

> > and neck. Abscesses develop within and eventually drain to the

> > surface where sulfur granules (yellowish gray masses), masses of

> > filamentous (long, threadlike structure) organisms, may be found

> in

> > the pus.

> >

> > Thoracic actinomycosis involves the lungs and mediastinum

(region

> > between the two lungs). The disease begins with fever, cough,

and

> > sputum production. The patient becomes weak, loses weight and

may

> > have night sweats and shortness of breath. Multiple sinuses may

> > extend through the chest wall, to the heart, or into the

abdominal

> > cavity. Ribs may be involved. Occasionally, cervicofacial and

> > thoracic disease may result in nervous system complications -

most

> > commonly brain abscesses or meningitis.

> >

> > Abdominal actinomycosis are mostly preceded by surgery such as

> > laparotomy for acute appendicitis, perforated ulcer, or

> gallbladder

> > inflammation. Infection usually begins in the gastrointestinal

> tract

> > and spreads to the abdominal wall. Spiking fever and chills,

> > intestinal colic, vomiting, and weight loss, a palpable (can be

> > felt) mass and an external sinus are evident in this type of

> > actinomycosis. This type of actinomycosis may be mistaken for

> > Crohn's disease, malignancy, tuberculosis, Amebiasis (an

infection

> > of the intestine or liver), or chronic appendicitis.

> >

> > Pelvic actinomycosis affects the women's pelvic area and may

cause

> > lower abdominal pain, fever, and bleeding between menstrual

> periods.

> > This form of the infection has been associated with the use of

> IUDs

> > (intra-uterine devices) that do not contain copper.

> >

> > Generalized actinomycosis may involve the skin, brain, liver and

> > urogenital system.

> >

> > Diagnosis of Actinomycosis

> > Actinomycosis may be hard to diagnose at onset. There are lab

> tests

> > that may isolate actinomyces in pus or tissue specimens.

> >

> > Treatment of Actinomycosis

> > Treatment for actinomycosis is long term, generally with up to

one

> > month of intravenous penicillin G, followed by weeks to months

of

> > penicillin taken by mouth. Additionally, surgical excision and

> > drainage of abscesses may be necessary.

> >

> > http://www.healthscout.com/ency/68/258/main.html

August 2, 2005

Will someone clear up for me the difference between

penicillin G and penicillin VK, I believe one web site

says VK was the drug of choice for actino. thanks jimd

--- lgrasso_hawaii <lgrasso_hawaii@...> wrote:

> Hi Penny:

>

> How did the doc dx actino...thru scans or did he

> take a biopsy?

>

> Tx,

>

> > Here are 2 articles on Actinomycosis. A very

> destructive, bone

> > eating bacteria that for many many years was

> thought to be a

> fungus

> > (hence the mycosis ending). A lot of docs still

> mistakenly assume

> > it's a fungus. A friend of mine recently, as a

> last resort, went

> to

> > a cancer specialist who routinely works with head

> and neck cancer

> > and he discovered that she was full of actino

> wormholing it's way

> > through her sinuses and jaw. He said he sees this

> all the time,

> and

> > isn't surprised, but that actino is very hard to

> detect or

> culture,

> > so most docs are oblivious. And, interestingly,

> Actinomycosis

> looks

> > much the same as lyme disease does on PCR testing.

> Acording to my

> > friend, when she talked to IGenex a couple years

> back, they told

> her

> > that it would be quite possible to confuse actino

> with lyme

> > organisms in PCR testing. Whether this still holds

> true, I don't

> > know, but I think it would make sense to find out,

> especially when

> > you read below how many areas Actino affects, and

> how difficult it

> > is to treat.

> >

> > It's also interesting that one of Actino's forms

> likes the lungs

> and

> > that it produces a granulomatous immune response.

> Perhaps it's the

> > cause of Sarcoidosis? It also can cause Pelvic

> disease in women,

> > tonsil problems, can affect the brain, etc. And

> debridement of the

> > jaw and sinuses is not, according to this cancer

> specialist, a

> good

> > way to go, because you will just keep debriding

> until there's no

> > bone left.

> >

> > Actino is probably most commonly introduced

> through dental or bone

> > trauma or even tissue injury (I'm thinking how

> many people seem

> > inexplicably stricken with CFS after a whip lash

> type injury).

> >

> > Actino apparently responds best to penicillin G,

> but treatment can

> > last a year or more. This is what my friend is

> currently doing.

> > Augmentin is also a drug that sometimes is

> beneficial.

> >

> > This is an organism that I think people should

> really be looking

> at

> > as a possible culprit in their illnesses.

> >

> > penny

> >

> > Actinomycosis is a subacute-to-chronic bacterial

> infection caused

> by

> > filamentous, gram-positive,

> anaerobic-to-microaerophilic bacteria

> > that are not acid fast. It is characterized by

> contiguous spread,

> > suppurative and granulomatous inflammatory

> reaction, and formation

> > of multiple abscesses and sinus tracts that

> discharge sulfur

> > granules. The most common clinical forms of

> actinomycosis are

> > cervicofacial (ie, lumpy jaw), thoracic, and

> abdominal. In women,

> > pelvic actinomycosis is common.

> >

> > Pathophysiology: The actinomycetes are prominent

> among the normal

> > flora of the oral cavity and less prominent in the

> lower

> > gastrointestinal tract and female genital tract.

> As these

> > microorganisms are not virulent, they require a

> break in the

> > integrity of the mucous membranes and the presence

> of devitalized

> > tissue to invade deeper body structures and cause

> human illness.

> >

> > Furthermore, actinomycosis generally is a

> polymicrobial infection,

> > with isolates numbering as many as 5-10 bacterial

> species.

> > Establishment of human infection may require the

> presence of such

> > companion bacteria, which participate in the

> production of

> infection

> > by elaborating a toxin or enzyme or by inhibiting

> host defenses.

> > These companion bacteria appear to act as

> copathogens that enhance

> > the relatively low invasive power of

> actinomycetes. Specifically,

> > they are responsible for the early manifestations

> of the infection

> > and for treatment failures.

> >

> > Once infection is established, the host mounts an

> intense

> > inflammatory (ie, suppurative, granulomatous)

> response, and

> fibrosis

> > develops subsequently. Infection typically spreads

> contiguously,

> > frequently ignoring tissue planes and invading

> surrounding tissues

> > or organs. Ultimately, the infection produces

> draining sinus

> tracts.

> > Hematogenous dissemination to distant organs may

> occur in any

> stage

> > of the infection, whereas lymphatic dissemination

> is unusual.

> >

> > Cervicofacial actinomycosis

> >

> > Cervicofacial actinomycosis is the most common

> manifestation,

> > comprising 50-70% of reported cases. Infection

> typically occurs

> > following oral surgery or in patients with poor

> dental hygiene.

> This

> > form of actinomycosis is characterized in the

> initial stages by

> soft-

> > tissue swelling of the perimandibular area. Direct

> spread into the

> > adjacent tissues occurs over time, along with

> development of

> > fistulas that discharge purulent material

> containing yellow (ie,

> > sulfur) granules. Invasion of the cranium or the

> bloodstream may

> > occur if the disease is left untreated.

> >

> > Thoracic actinomycosis

> >

> > Thoracic actinomycosis accounts for 15-20% of

> cases. Aspiration of

> > oropharyngeal secretions containing actinomycetes

> is the usual

> > mechanism of infection. Occasionally, thoracic

> actinomycosis may

> > result from the introduction of organisms via

> esophageal

> > perforation, by direct spread from an

> actinomycotic process of the

> > neck or abdomen, or via hematogenous spread from a

> distant lesion.

> > Thoracic actinomycosis commonly presents as a

> pulmonary infiltrate

> > or mass, which, if left untreated, can spread to

> involve the

> pleura,

> > pericardium, and chest wall, ultimately leading to

> the formation

> of

> > sinuses that discharge sulfur granules.

> >

> > Actinomycosis of the abdomen and pelvis

> >

> > Actinomycosis of the abdomen and pelvis accounts

> for 10-20% of

>

=== message truncated ===

____________________________________________________

Start your day with - make it your home page

http://www./r/hs

August 2, 2005

Penicillin G is the IV adminstered very short shelf life, real deal,

genuine, real mccoy penicillin. The penicillin VK is the trying to

cut down infusion and extraction times from the body so you can use

it less frequent and it also can be done pill form.The big

difference is the salts the drug is suspended in I think pen G is

suspended in potassium salts.I also think there may be a slight

twist on the molecullar structure in one of the rings. I haven't

really looked at this for a long time so don't quote me, my advise

is just a brief outline.

> > > Here are 2 articles on Actinomycosis. A very

> > destructive, bone

> > > eating bacteria that for many many years was

> > thought to be a

> > fungus

> > > (hence the mycosis ending). A lot of docs still

> > mistakenly assume

> > > it's a fungus. A friend of mine recently, as a

> > last resort, went

> > to

> > > a cancer specialist who routinely works with head

> > and neck cancer

> > > and he discovered that she was full of actino

> > wormholing it's way

> > > through her sinuses and jaw. He said he sees this

> > all the time,

> > and

> > > isn't surprised, but that actino is very hard to

> > detect or

> > culture,

> > > so most docs are oblivious. And, interestingly,

> > Actinomycosis

> > looks

> > > much the same as lyme disease does on PCR testing.

> > Acording to my

> > > friend, when she talked to IGenex a couple years

> > back, they told

> > her

> > > that it would be quite possible to confuse actino

> > with lyme

> > > organisms in PCR testing. Whether this still holds

> > true, I don't

> > > know, but I think it would make sense to find out,

> > especially when

> > > you read below how many areas Actino affects, and

> > how difficult it

> > > is to treat.

> > >

> > > It's also interesting that one of Actino's forms

> > likes the lungs

> > and

> > > that it produces a granulomatous immune response.

> > Perhaps it's the

> > > cause of Sarcoidosis? It also can cause Pelvic

> > disease in women,

> > > tonsil problems, can affect the brain, etc. And

> > debridement of the

> > > jaw and sinuses is not, according to this cancer

> > specialist, a

> > good

> > > way to go, because you will just keep debriding

> > until there's no

> > > bone left.

> > >

> > > Actino is probably most commonly introduced

> > through dental or bone

> > > trauma or even tissue injury (I'm thinking how

> > many people seem

> > > inexplicably stricken with CFS after a whip lash

> > type injury).

> > >

> > > Actino apparently responds best to penicillin G,

> > but treatment can

> > > last a year or more. This is what my friend is

> > currently doing.

> > > Augmentin is also a drug that sometimes is

> > beneficial.

> > >

> > > This is an organism that I think people should

> > really be looking

> > at

> > > as a possible culprit in their illnesses.

> > >

> > > penny

> > >

> > > Actinomycosis is a subacute-to-chronic bacterial

> > infection caused

> > by

> > > filamentous, gram-positive,

> > anaerobic-to-microaerophilic bacteria

> > > that are not acid fast. It is characterized by

> > contiguous spread,

> > > suppurative and granulomatous inflammatory

> > reaction, and formation

> > > of multiple abscesses and sinus tracts that

> > discharge sulfur

> > > granules. The most common clinical forms of

> > actinomycosis are

> > > cervicofacial (ie, lumpy jaw), thoracic, and

> > abdominal. In women,

> > > pelvic actinomycosis is common.

> > >

> > > Pathophysiology: The actinomycetes are prominent

> > among the normal

> > > flora of the oral cavity and less prominent in the

> > lower

> > > gastrointestinal tract and female genital tract.

> > As these

> > > microorganisms are not virulent, they require a

> > break in the

> > > integrity of the mucous membranes and the presence

> > of devitalized

> > > tissue to invade deeper body structures and cause

> > human illness.

> > >

> > > Furthermore, actinomycosis generally is a

> > polymicrobial infection,

> > > with isolates numbering as many as 5-10 bacterial

> > species.

> > > Establishment of human infection may require the

> > presence of such

> > > companion bacteria, which participate in the

> > production of

> > infection

> > > by elaborating a toxin or enzyme or by inhibiting

> > host defenses.

> > > These companion bacteria appear to act as

> > copathogens that enhance

> > > the relatively low invasive power of

> > actinomycetes. Specifically,

> > > they are responsible for the early manifestations

> > of the infection

> > > and for treatment failures.

> > >

> > > Once infection is established, the host mounts an

> > intense

> > > inflammatory (ie, suppurative, granulomatous)

> > response, and

> > fibrosis

> > > develops subsequently. Infection typically spreads

> > contiguously,

> > > frequently ignoring tissue planes and invading

> > surrounding tissues

> > > or organs. Ultimately, the infection produces

> > draining sinus

> > tracts.

> > > Hematogenous dissemination to distant organs may

> > occur in any

> > stage

> > > of the infection, whereas lymphatic dissemination

> > is unusual.

> > >

> > > Cervicofacial actinomycosis

> > >

> > > Cervicofacial actinomycosis is the most common

> > manifestation,

> > > comprising 50-70% of reported cases. Infection

> > typically occurs

> > > following oral surgery or in patients with poor

> > dental hygiene.

> > This

> > > form of actinomycosis is characterized in the

> > initial stages by

> > soft-

> > > tissue swelling of the perimandibular area. Direct

> > spread into the

> > > adjacent tissues occurs over time, along with

> > development of

> > > fistulas that discharge purulent material

> > containing yellow (ie,

> > > sulfur) granules. Invasion of the cranium or the

> > bloodstream may

> > > occur if the disease is left untreated.

> > >

> > > Thoracic actinomycosis

> > >

> > > Thoracic actinomycosis accounts for 15-20% of

> > cases. Aspiration of

> > > oropharyngeal secretions containing actinomycetes

> > is the usual

> > > mechanism of infection. Occasionally, thoracic

> > actinomycosis may

> > > result from the introduction of organisms via

> > esophageal

> > > perforation, by direct spread from an

> > actinomycotic process of the

> > > neck or abdomen, or via hematogenous spread from a

> > distant lesion.

> > > Thoracic actinomycosis commonly presents as a

> > pulmonary infiltrate

> > > or mass, which, if left untreated, can spread to

> > involve the

> > pleura,

> > > pericardium, and chest wall, ultimately leading to

> > the formation

> > of

> > > sinuses that discharge sulfur granules.

> > >

> > > Actinomycosis of the abdomen and pelvis

> > >

> > > Actinomycosis of the abdomen and pelvis accounts

> > for 10-20% of

> >

> === message truncated ===

>

> ____________________________________________________

> Start your day with - make it your home page

> http://www./r/hs

August 2, 2005

Yeah, diff molecules. G is the original dope, produced by Penicillium

notatum (or whatever it is) and discovered by Fleming. AKA

benzylpenicillin. VK is not in my little book here, but I know they

swap out some of the chemical groups on one side chain of the

molecule to produce the different ones.

Is there a good means of dx determination for actinomycosis? Doesnt

look too common from that article, at least according to whomever

wrote it.

> > > > Here are 2 articles on Actinomycosis. A very

> > > destructive, bone

> > > > eating bacteria that for many many years was

> > > thought to be a

> > > fungus

> > > > (hence the mycosis ending). A lot of docs still

> > > mistakenly assume

> > > > it's a fungus. A friend of mine recently, as a

> > > last resort, went

> > > to

> > > > a cancer specialist who routinely works with head

> > > and neck cancer

> > > > and he discovered that she was full of actino

> > > wormholing it's way

> > > > through her sinuses and jaw. He said he sees this

> > > all the time,

> > > and

> > > > isn't surprised, but that actino is very hard to

> > > detect or

> > > culture,

> > > > so most docs are oblivious. And, interestingly,

> > > Actinomycosis

> > > looks

> > > > much the same as lyme disease does on PCR testing.

> > > Acording to my

> > > > friend, when she talked to IGenex a couple years

> > > back, they told

> > > her

> > > > that it would be quite possible to confuse actino

> > > with lyme

> > > > organisms in PCR testing. Whether this still holds

> > > true, I don't

> > > > know, but I think it would make sense to find out,

> > > especially when

> > > > you read below how many areas Actino affects, and

> > > how difficult it

> > > > is to treat.

> > > >

> > > > It's also interesting that one of Actino's forms

> > > likes the lungs

> > > and

> > > > that it produces a granulomatous immune response.

> > > Perhaps it's the

> > > > cause of Sarcoidosis? It also can cause Pelvic

> > > disease in women,

> > > > tonsil problems, can affect the brain, etc. And

> > > debridement of the

> > > > jaw and sinuses is not, according to this cancer

> > > specialist, a

> > > good

> > > > way to go, because you will just keep debriding

> > > until there's no

> > > > bone left.

> > > >

> > > > Actino is probably most commonly introduced

> > > through dental or bone

> > > > trauma or even tissue injury (I'm thinking how

> > > many people seem

> > > > inexplicably stricken with CFS after a whip lash

> > > type injury).

> > > >

> > > > Actino apparently responds best to penicillin G,

> > > but treatment can

> > > > last a year or more. This is what my friend is

> > > currently doing.

> > > > Augmentin is also a drug that sometimes is

> > > beneficial.

> > > >

> > > > This is an organism that I think people should

> > > really be looking

> > > at

> > > > as a possible culprit in their illnesses.

> > > >

> > > > penny

> > > >

> > > > Actinomycosis is a subacute-to-chronic bacterial

> > > infection caused

> > > by

> > > > filamentous, gram-positive,

> > > anaerobic-to-microaerophilic bacteria

> > > > that are not acid fast. It is characterized by

> > > contiguous spread,

> > > > suppurative and granulomatous inflammatory

> > > reaction, and formation

> > > > of multiple abscesses and sinus tracts that

> > > discharge sulfur

> > > > granules. The most common clinical forms of

> > > actinomycosis are

> > > > cervicofacial (ie, lumpy jaw), thoracic, and

> > > abdominal. In women,

> > > > pelvic actinomycosis is common.

> > > >

> > > > Pathophysiology: The actinomycetes are prominent

> > > among the normal

> > > > flora of the oral cavity and less prominent in the

> > > lower

> > > > gastrointestinal tract and female genital tract.

> > > As these

> > > > microorganisms are not virulent, they require a

> > > break in the

> > > > integrity of the mucous membranes and the presence

> > > of devitalized

> > > > tissue to invade deeper body structures and cause

> > > human illness.

> > > >

> > > > Furthermore, actinomycosis generally is a

> > > polymicrobial infection,

> > > > with isolates numbering as many as 5-10 bacterial

> > > species.

> > > > Establishment of human infection may require the

> > > presence of such

> > > > companion bacteria, which participate in the

> > > production of

> > > infection

> > > > by elaborating a toxin or enzyme or by inhibiting

> > > host defenses.

> > > > These companion bacteria appear to act as

> > > copathogens that enhance

> > > > the relatively low invasive power of

> > > actinomycetes. Specifically,

> > > > they are responsible for the early manifestations

> > > of the infection

> > > > and for treatment failures.

> > > >

> > > > Once infection is established, the host mounts an

> > > intense

> > > > inflammatory (ie, suppurative, granulomatous)

> > > response, and

> > > fibrosis

> > > > develops subsequently. Infection typically spreads

> > > contiguously,

> > > > frequently ignoring tissue planes and invading

> > > surrounding tissues

> > > > or organs. Ultimately, the infection produces

> > > draining sinus

> > > tracts.

> > > > Hematogenous dissemination to distant organs may

> > > occur in any

> > > stage

> > > > of the infection, whereas lymphatic dissemination

> > > is unusual.

> > > >

> > > > Cervicofacial actinomycosis

> > > >

> > > > Cervicofacial actinomycosis is the most common

> > > manifestation,

> > > > comprising 50-70% of reported cases. Infection

> > > typically occurs

> > > > following oral surgery or in patients with poor

> > > dental hygiene.

> > > This

> > > > form of actinomycosis is characterized in the

> > > initial stages by

> > > soft-

> > > > tissue swelling of the perimandibular area. Direct

> > > spread into the

> > > > adjacent tissues occurs over time, along with

> > > development of

> > > > fistulas that discharge purulent material

> > > containing yellow (ie,

> > > > sulfur) granules. Invasion of the cranium or the

> > > bloodstream may

> > > > occur if the disease is left untreated.

> > > >

> > > > Thoracic actinomycosis

> > > >

> > > > Thoracic actinomycosis accounts for 15-20% of

> > > cases. Aspiration of

> > > > oropharyngeal secretions containing actinomycetes

> > > is the usual

> > > > mechanism of infection. Occasionally, thoracic

> > > actinomycosis may

> > > > result from the introduction of organisms via

> > > esophageal

> > > > perforation, by direct spread from an

> > > actinomycotic process of the

> > > > neck or abdomen, or via hematogenous spread from a

> > > distant lesion.

> > > > Thoracic actinomycosis commonly presents as a

> > > pulmonary infiltrate

> > > > or mass, which, if left untreated, can spread to

> > > involve the

> > > pleura,

> > > > pericardium, and chest wall, ultimately leading to

> > > the formation

> > > of

> > > > sinuses that discharge sulfur granules.

> > > >

> > > > Actinomycosis of the abdomen and pelvis

> > > >

> > > > Actinomycosis of the abdomen and pelvis accounts

> > > for 10-20% of

> > >

> > === message truncated ===

> >

> > ____________________________________________________

> > Start your day with - make it your home page

> > http://www./r/hs

August 2, 2005

Hi Penny,

Do you know which specific lab tests diagnose this? I remember that

you said earlier that there were very few doctors in the US who are

skilled enough to recognize these kinds of bone-eating bacteria.

Could you supply us some names and contact information?

I think this is a very relevent topic for alot of us, but we need to

know where to go to have the appropriate work-up.

Thanks,

Pippit