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If actinomyces spreads to penetrate the central nervous system, maybe death will come to him

Written By Hanny & Melissa on Wednesday, May 08, 2019 | Wednesday, May 08, 2019

Actinomycosis infection is characterized by swelling that is centralized or localized in a place, accompanied by pus formation due to inflammation (Suppuration), fibrosis, formation of abscesses, as well as discharge of fluid containing sulfur granules from the sinus tract in the abscess.

Meanwhile, Actinomycosis is a subacute chronic infection caused by the bacterium genus Actinomyces. Actinomycosis is quite rare and the infection is local in one place in the body part.

This is because Actinomyces bacteria do not have the ability to penetrate body tissues. However, in some cases, Actinomyces bacteria can move through the body's tissues even though it is very slow.

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The characteristics of actinomycosis symptoms vary depending on the type of infection that occurs. Several types of symptoms of actinomycosis that have been identified are:

1. Oral cervicofacial actinomycosis.

- This type of actinomycosis infection occurs in the mouth, oral cavity, jaw, neck and facial area.

Most cases of oralis actinomycosis are caused by problems in the jaw (Such as a jaw injury) or problems with the teeth and gums (Such as tartar and tooth decay).

2. Actinomycosis thoracic.

- This is a type of actinomycosis infection that occurs in the lungs or other respiratory organs.

The majority of pulmonary actinomycosis infections are thought to be caused by inhalation of spit or liquid contaminated with Actinomyces into the respiratory organs.

3. Abdominal actinomycosis.

- Actinomycosis infection that occurs in the abdomen. The causes of the emergence of abdominal actinomycosis are very diverse, one of which is due to infection of the appendix.

4. Pelvic actinomycosis.

- This is an actinomycosis infection that occurs in the pelvis (Pelvic area). some sufferers of this type of infection are women due to the spread of bacteria from the genital organs to the pelvis.

Pelvic actinomycosis is often associated with the use of an IUD constructive device. Especially if the use exceeds the time limit recommended by the manufacturer.

However, it is rare to know the cause of actinomycosis. The cause is Actinomyces bacteria which is a normal flora that normally lives in the oral cavity, digestive tract and urinary tract.

Actinomyces bacteria are facultative pathogenic comensal bacteria that require the ability to penetrate the mucous layer so that it can cause disease.

Actinomycosis is often caused by several types of bacteria, both fellow genera of Actinomyces or other bacteria. The bacteria Actinomyces israelii and Actinomyces gerencseriae are two of the most common bacteria in cases of actinomycosis in humans.

In addition to these two types of bacteria, the types of Actinomyceslain bacteria that can be found in the case of actinomycosis include Actinomyces odontolyticus, Actinomyces viscous, Actinomyces meyeri, Actinomyces turicensis, and Actinomyces radingae.

Infections that occur due to Actinomyces tend to appear on tissues adjacent to the mucous membrane. Some things that can increase the likelihood of a person being exposed to actinomycosis include:

1. Age.

Actinomycosis occurs most often at the age of 20-60 years.

2. Men.

Actinomycosis often occurs in men, except for pelvic actinomycosis which tends to occur in women.

3. Diabetes.

4. Immunosuppression.

The condition of a person's immune system is disrupted causing it to be more susceptible to actinomycosis. For example due to HIV infection, undergoing chemotherapy, taking steroids, bisphosphonates, kidney transplants, or lung transplants.

5. Consuming alcohol.

6. Having tissue damage.

For example due to injury, surgery, or radiotherapy.

7. Tooth decay or dental hygiene that is not properly maintained, and has a history of surgery on the abdomen.

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Furthermore, for the symptoms of actinomycosis it is quite varied depending on the location of the occurrence of this condition. And the symptoms of oral servikofasial actinomycosis that often appear include:

1. Fever.

2. The appearance of chronic swelling around the lower jaw that is not painful. But sometimes this swelling can also cause pain.

3. The appearance of lesions that feel hard and often mistaken for malignant lesions (Cancer).

4.the appearance of lymphadeopathy if actinomycosis is chronic enough and enters an advanced stage.

5. Formed pus channel (Sinus), which emits yellow pus fluid like sulfur.

6. The color of the skin around the swelling can turn reddish or bluish.

7. Oral servicophasial actinomycosis in some cases can also spread to bones and muscles.

Then in the case of thoracic actinomycosis, the symptoms that often appear are as follows:

1. Mild to moderate fever.

2. Cough that appears can be a dry cough or cough with phlegm. In some cases, blood coughing can also appear.

3. Tired and tired.

4. Shortness of breath, chest pain.

5. Coughing up blood (Haemoptysis) and losing weight if an actinomycosis infection has been going on for a long time.

6. There is fluid in the lungs which is sometimes followed by the appearance of a lump in the lung area.

7. Then if left unchecked, the infection can spread to the lining of the lungs, the lining of the heart, and the lining of the chest.

So on, in the case of abdominal actinomycosis, the symptoms that can arise are:

1. Mild fever.

2. Losing weight.

3. Tired and tired, abdominal pain.

4. The appearance of a lump or swelling in the lower abdomen. But sometimes the lump is not felt during the physical examination using the palpation method.

5. The appearance of pus fluid from the sinus that forms on the abdomen.

6. Diarrhea or constipation, nausea and vomiting.

Whereas in the case of pelvic actinomycosis, the symptoms that can arise are :

1. Kower abdominal pain.

2. Irregular vaginal bleeding or vaginal discharge such as vaginal discharge.

3. Loss of appetite.

4. The appearance of a lump that can be felt in the waist or hip area.

5. A mild, tired fever.

Actinomycosis and Treatment...

The most important step to treat Actinomycosis is to use antibiotics, especially beta-lactam groups, such as penicillin G, and penicillin V.

The ability of Actinomyces bacteria to be resistant to penicillin is quite low, so that this class of antibiotics can be used as the main treatment for actinomycosis.

Yreatment in the first stage can use intravenous penicillin G for 2-6 weeks, then followed by oral penicillin V for 6-12 months.

But keep in mind that treatment for 6-12 months is not necessary for all sufferers of actinomycosis. Besides using penicillin, actinomycosis can also be treated using antibiotics as follows:

1. Benzylpenicillin.
2. Amoxicillin.
3. Ceftriaxone.
4. Meropenem.
5. Piperacillin and tazobactam.
6. Doxycycline.
7. Clindamycin.
8. Erythromycin, and Clarithromycin.

In actinomycosis patients, often not only the genus Actinomyces is found in the area of actinomycosis, but is more dominant than other bacteria, such as Staphylococcus aureus and anaerobic gram-negative bacteria.

Therefore, when administering antibiotics at the beginning of the treatment period, antibiotics also need to be able to inhibit the beta-lactamase enzyme.

Beta lactamase can inhibit the performance of antibiotics given to kill Actinomyces. Examples of antibiotics that also have the ability to inhibit beta-lactamase are clavulanate and tazobactam.

And the most important for patients with abdominal actinomycosis, besides being given amoxicillin, metronidazole, clindamycin, or clavulanate, aminoglycosides can also be given.

The function of aminoglycosides is to eradicate the bacterium Enterobacteriaceae family that is resistant to previous antibiotics, and aggravate the actinomycosis that occurs.

Surgery can indeed be done in patients with actinomycosis, but keep in mind that the primary method of actinomycosis treatment is through antibiotics. Some conditions that cause actinomycosis need to be treated surgically, including:

1. If there is extensive tissue damage and tissue resection or other actions need to be done. For example if there is necrosis, sinus infection, and the appearance of a fistula.

2. If there is a large abscess or empyema (pus containing abscess) that cannot be dried through suctioning from the surface of the skin.

3. If an abscess that appears obstructs the organs of the body - for example if an abscess in actinomycosis pelvis obstructs the urinary tract.

Actinomycosis can cause death especially if the Actinomyces infection spreads to the central nervous system such as the brain and spinal cord.

The death rate from actinomycosis can reach 28 percent, but the rate depends on the initial location of the occurrence of actinomycosis. And if patients get good medical care and treatment, actinomycosis sufferers can recover fully. Happy weekend...

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