Actinomycosis Definition, Reason, Diagnosis, Symptom, Treatment

Actinomycosis is an infection caused by the bacteria Actinomyces spp., which are anaerobic gram-positive bacteria.


Actinomycosis is an infection caused by the bacteria Actinomyces spp., which are anaerobic gram-positive bacteria. These bacteria usually colonize the mouth, digestive tract, and urinary and reproductive tracts of humans.

This disease is characterized by swelling of the infected area, accompanied by discharge of pus. This infection is classified as rare case and is usually only local. ACTINOMYCOSIS According To ilovepathology


There are more than 30 types of Actinomyces bacteria. Among these species, Actinomyces israelii is the bacteria most commonly found in actinomycosis infections in humans. Other types of bacteria, such as Actinomyces viscous and Actinomyces meyeri, can also be found in actinomycosis although less frequently.

Actinomyces is part of the normal flora. To be able to cause disease in humans, it is necessary to have damage to the mucous membranes and the presence of weak or dead body tissue, so that bacteria can invade internal body structures. Actinomycosis is a polymicrobial disease, meaning that many microbes are involved in causing the disease, which can range from 5 to 10 types of bacteria.

After infection occurs, the patient’s body will give an intense inflammatory reaction and can be followed by fibrosis. Generally, the infection will spread and attack surrounding tissues or organs. This infectious process can create drainage pathways (fistulas). In this disease, spread through the blood (hematogenous) can occur at any stage of the infection, meanwhile, spread through the lymph tissue is rare.


Actinomycosis is difficult to diagnose based on clinical symptoms alone. Therefore, it is generally necessary to assist with supporting examinations. The definitive diagnosis is made by performing culture of the organism. Samples are generally obtained from a biopsy, needle aspiration, or pus from the drainage line. Cultures can take 2-3 weeks.

The initial examination can be done by examining the pus under a microscope to see the characteristics of the Actinomyces bacteria and a picture of inflammation. Imaging tests, such as X-rays or CT scans, can help show a mass or lump in the body.


Symptoms depend on the part of the body affected by actinomycosis, namely:

  • cervicofacial actinomycosis

o There is a history of dental manipulation or trauma to the oral area, has poor oral and dental hygiene.

There is a lump that is not painful or only occasionally painful in the submandibular and perimandibular areas. These lumps can increase in number and size. In the early stages, the lump is usually soft but becomes firm over time.

o The lump over time can release granules filled with pus.

o change in skin color to redness or bluish in the affected area.

or difficulty chewing.

  • thoracic actinomycosis

o history of aspiration (risk factors are seizures, alcohol abuse, and poor oral health).

o dry cough or phlegm, difficulty breathing (snoring ), chest pain, and sometimes sputum accompanied by blood (coughing up blood).

  • Abdominal actinomycosis

o history of surgery on the stomach, ingested foreign objects (eg fish or chicken bones), and so on.

o the appearance of non-specific symptoms, such as fever with low temperature, weight loss, weakness/fatigue, changes in bowel pattern, nausea and vomiting, vague abdominal pain, lumps (most often in the lower right area).

  • pelvic actinomycosis

o history of long IUD use (if using an IUD, pay attention to when to remove the IUD). Generally, in cases of pelvic actinomycosis associated with IUD use, the average use of this contraceptive is 8 years.

o pain in the lower abdominal area, vaginal bleeding or discharge from the vagina.

o other symptoms may be similar to those of abdominal actinomycosis.


In most cases, treatment with antibiotics is sufficient to treat cases of actinomycosis. The type of antibiotic of choice is Penicillin g. Treatment takes a long time, so it is important for patients to keep regular checkups and take antibiotics even if they feel better.

Sometimes, surgical assistance is also needed to remove infected tissue (eg abscesses on the inside of the body).

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