What is the treatment for Actinomyces?

In most cases of actinomycosis, antimicrobial therapy is the only treatment required, although surgery can be adjunctive in selected cases. Penicillin G is the drug of choice for treating infections caused by actinomycetes. Parenteral antibiotics are administered initially via PICC line, with transition to oral agents.

Why are there Sulphur granules in actinomycosis?

Yellowish sulfur granules are constituted by conglomeration of bacteria trapped in biofilm. These findings are highly suggestive of the diagnosis but are not specific, as they can be encountered in other pathogenic conditions such as nocardiosis or chronic cervicofacial fungal infections.

Does Nocardia produce sulfur granules?

In addition, Nocardia spp. are partially acid fast staining, whereas Actinomyces spp. are not. Effusions and exudates may contain malodorous, macroscopic sulfur granules, which appear as tan/grey aggregates1 (Figure 92-4).

How do you differentiate Actinomyces and Nocardia?

Nocardia can usually be differentiated from Actinomyces by acid-fast staining, as Nocardia typically exhibit varying degrees of acid fastness due to the mycolic acid content of the cell wall (picture 2).

Does meropenem cover Actinomyces?

For CNS involvement, it may be preferred to give meropenem, but experience with that drug is less. This drug won’t work. Actinomyces are not susceptible in vitro. This means Actinomycetes are probably not true anaerobes.

What stain is used for Actinomyces?

Nocardia stain partially acid-fast, Actinomyces and Streptomyces are not acid-fast. Actinomyces and Streptomyces produce granules. Most actinomycetes in tissue do not stain with the H & E stain commonly used for general histopathology. All genera may produce granules.

Can Actinomyces grow aerobically?

Actinomyces Species Actinomyces cannot be distinguished from Nocardia on Gram stain. However, Nocardia spp. grow aerobically and stain with acid-fast technique, and Actinomyces spp.

How do you treat Nocardia?

Nocardia organisms are usually resistant to penicillin. Sulfonamide drugs may be prescribed. However, since most cases respond slowly, treatment with sulfonamide drugs must be continued for several months. Trimethoprim-sulfamethoxazole is often prescribed for immunosuppressed patients.

What are Actinomyces and Nocardia?

Actinomyces and Nocardia are gram-positive rods characterized by filamentous, tree-like branching growth, which has caused them to be confused with fungi in the past. They are opportunists that can sometimes produce indolent, slowly progressive diseases.

What are the treatment options for Actinomyces spp?

High doses of penicillin given for prolonged periods (weeks to months) is the treatment of choice (Table 47-2). 101 No strains of Actinomyces spp. have shown in vitro resistance to easily attainable serum concentrations of penicillin, and acquired resistance in vivo has not been confirmed.

How is genitourinary tract actinomycosis (GTA) treated?

Patients with genitourinary tract actinomycosis usually receive several weeks of intravenous high doses of a beta-lactam, followed by oral therapy for 2–6 months.

How is the diagnosis of actinomycosis made?

The diagnosis is mainly based on stereotaxic aspiration of pus, revealing Actinomycesspp. in cultures and sulfur granules in pathology.1–3,82–84 Current and emerging treatment options The treatment of actinomycosis brain abscess requires prolonged antimicrobial therapy after pus aspiration.1–3,82–84

Is penicillin G good for actinomycosis?

Indeed, Actinomyces spp. are usually extremely susceptible to beta-lactams, and especially penicillin G or amoxicillin. As a consequence, penicillin G or amoxicillin are considered drugs of choice for the treatment of actinomycosis.