Actinomycosis
As actinomycosis a disease is called, which is also known under the term ray fungus in Germany. It is caused, inter alia, as a mixed infection by bacteria from the group of actinomycetes. Previously it was assumed erroneously that it is a fungal infection RELATES ( pseudomycosis ).
Actinomycosis is a bacterial anaerobic and aerobic mixed infection, which is caused mainly by the germ Actinomyces israelii, but other actinomycetes. This is part of the normal oral flora of humans and penetrates at a breach of the mucosa into deeper tissue layers. Now here there is a purulent inflammation with the formation of granulation tissue and branched fistulas. The most common clinical presentation is the cervicofacial actinomycosis (ie, the neck, the face, usually around the mouth ), whereas the incidence in the CNS, lungs ( aspiration = inhalation ) as well as in the skin is rare. It also describes Aktinomykosen the mammary gland, as well as in the genital area, usually associated with long lying intrauterine devices.
Diagnosis is made by examination of the sputum or lung biopsy. The cultivation of the pathogen must be exceptionally long, that is made at least two weeks because actinomycetes proliferate slowly. Actinomycosis is not contagious. It is characterized by a chronic course with high Rezidivität. The therapy consists of the administration of Aminopenicillin, initially intravenously. This treatment may take up to a year. Recent studies suggest a short-term therapy for up to three months. Alternatively, tetracycline or cephalosporin may be used. High doses of iodine should also have a favorable effect. When surgical therapy (read: surgery) the inflammatory focus is opened and the affected tissue removed.
The main complication is in the occurring in actinomycosis fistula. This allows the pathogen to enter the bloodstream, and the disease may be systemic ( on the whole body ) is. Due to the high Rezidivität the prognosis is not good. The thoracic form of infection remains untreated burdened with a high risk of health and life of patients. Also extensive thoracic diseases respond very well to antibiotic therapy. A surgical or interventional therapy (drainage) is currently being conducted in about half the cases, which is probably too often.