Actinomycosis - mistaken as lyme?

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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