title: Actinomycosis: a frequently forgotten disease.
abstract: Actinomycosis is a rare subacute or chronic, endogenous infection mainly by Actinomyces species, showing low virulence through fimbriae and biofilms. Cervicofacial, thoracic, abdominal, pelvic and sometimes cerebral, laryngeal, urinary and other regions can be affected. Actinomycosis mimics other diseases, often malignancy. Disease risk in immunocompromised subjects needs clarification. Diagnosis is often delayed and 'sulfur granules' are helpful but nonspecific. Culture requires immediate specimen transport and prolonged anaerobic incubation. Imaging, histology, cytology, matrix-assisted laser desorption ionization time-of-flight mass spectrometry and molecular methods improve the diagnosis. Actinomycetes are β-lactam susceptible, occasionally resistant. Treatment includes surgery and/or long-term parenteral then oral antibiotics, but some 1-4-week regimens or oral therapy alone were curative. For prophylaxis, oral hygiene and regular intrauterine device replacement are important.
authors: Department of Medical Microbiology, Medical University of Sofia, Bulgaria.
authors: Lyudmila
authors: L
authors: Boyanova
authors: Rossen
authors: R
authors: Kolarov
authors: Lyudmila
authors: L
authors: Mateva
authors: Rumyana
authors: R
authors: Markovska
authors: Ivan
authors: I
authors: Mitov
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques / Q000379:methods*; D003646:Debridement; D003955:Diagnostic Tests, Routine / Q000379:methods*; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents
keywords: A. israelii; Actinomyces; actinomycosis; diagnosis; immunocompromised; molecular methods; prophylaxis; shorter regimens; treatment; virulence