Fungi-like bacteriaFungi-like bacteria

Actinomyces speciesActinomyces species

Nocardia speciesNocardia species

Streptomyces speciesStreptomyces species

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ActinomycetesActinomycetes

Aerobic gram-positive Aerobic gram-positive bacillibacilli NocardiaNocardia ActinomaduraActinomadura NocardiopsisNocardiopsis StreptomycesStreptomyces

Anaerobic non-spore fAnaerobic non-spore forming gram-positive orming gram-positive bacillibacilli ActinomycesActinomyces

Gram Positive Filamentous BacteriaGram Positive Filamentous Bacteria

GENUSGENUS OXYGENOXYGEN GRANULEGRANULE ACIDFASTACIDFAST

MycobacteriaMycobacteria aerobeaerobe nono yesyes

ActinomycesActinomyces ANAEROBEANAEROBE YESYES nono

NocardiaNocardia aerobeaerobe sometime sometime

PARTIALLYPARTIALLY

StreptomycesStreptomyces aerobeaerobe YESYES nono

PhysiologyPhysiology BacteriaBacteria with fungi-like str with fungi-like str

uctures.uctures.

Actinomycetes are true baActinomycetes are true bacteriacteria lack of nucleus membrane alack of nucleus membrane a

nd mitochondriand mitochondria susceptibility to antibacterial susceptibility to antibacterial

but not to antifungal but not to antifungal

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Acid-fast stain of Nocardia sp.

PhysiologyPhysiology There are There are aerobic and anaerobicaerobic and anaerobic actinomy actinomy

cetescetes Aerobe; ; Nocardia, Actinomadura, StreptomycNocardia, Actinomadura, Streptomyc

eses Anaerobe; ; ActinomycesActinomyces

Slowly growingSlowly growing 3 days - 2 weeks3 days - 2 weeks

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Nocardia growing in culture after 7 days as colony that are chalky and raised,with color varying from white to yellow-orange

DiseasesDiseasesActinomycetomaActinomycetomaNocardiosis Nocardiosis (Nocardial infection)(Nocardial infection)

ActinomycosisActinomycosis

Modified acid-fast stainModified acid-fast stain

Acid-fast stain carbolfuchsin 3%HCl-alcohol

Methylene blue

Modified acid-fast stain carbofuchsin 1% H2SO4- alcohol

Methylene blue

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ActinomycosisActinomycosis Lumpy jaw Chronic disease characterized by formation of

multiple abscesses and sinus tracts that discharge sulfur granules

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ActinomycosisActinomycosis Etiologic agent: Anaerobic bacteria

Actinomyces israeli, A. gerencseriae A. naeslundii, A.odontolyticus, A. viscosus

Gram-positive branching filamentous, no spore forming

Acid-fast negative

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ActinomycosisActinomycosis Source : Normal flora of the upper respiratory, g

astrointestinal and female genital tracts

3 major clinical types Cervicofacial actinomycosis (50-70%) Thoracic actinomycosis (15-20%) Abdominal & pelvic actinomycosis (10-20%)

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ActinomycosisActinomycosis

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ActinomycosisActinomycosis Laboratory diagnosis

Specimen : pus, sputum, skin biopsy

Naked eye ; sulfur granule

10 % KOH, Gram’s stain

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Sulphur

granules

ActinomycosisActinomycosis

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A) Microscope view of actinomycotic “sulfur granules” (10x) (Exudate from an abdominal wound infection)

B) Gram-stained smear from the specimen as in A), showing thin sulfur granule with thin, branching filaments (800x)

ActinomycosisActinomycosis Laboratory diagnosis

Cultures immediately under anaerobic conditions and incubated for 48 hours or require 2-3 weeks.

Typical colonies have "molar tooth" appearance on agar

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Molar tooth colony

ActinomycosisActinomycosis Treatment

1 to 2 months of penicillin given through a vein, followed by 6 to 12 months of penicillin taken by mouth.

co-trimoxasole, chloramphenicol, methicilin

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