With this form of actinomycosis, the influence of the attached secondary pyogenic infection is most clearly manifested, which makes the course of the disease more acute and stormy and usuallybut contributes to the spread of the process along the length. A special place is occupied by the primary lesion of the jaw bone tissue by actinomycosis, which proceeds as a destructive or productive-destructive process. According to the clinical and radiological picture, the disease resembles the development of an odontogenic tumor or a malignant neoplasm.

Actinomycosis of the oral organs (tongue, salivary glands, tonsils) is relatively rare. A significant variety of manifestations is characterized by actinomycosis of the tongue, which depends on the localization of a specific granuloma in its tissues. The process can affect the superficial parts of cytotec pills, be located in the thickness of the muscle tissue of the back or tip of the tongue in the form of limited infiltrates; diffuse lesions are also observed, resembling a banal abscess and phlegmon of the base of the tongue.

In some cases, actinomycosis secondarily affects the lower jaw, less often the upper, rarely the zygomatic and temporal bones. In this case, a picture of extensive ossifying periostitis arises, sometimes in combination with a number of usurations of the cortical substance of the bone, sometimes there is a progressive destruction of cytotec online sections.

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Generalized actinomycosis. Cases of multiple hematogenous metastasis of actinomycosis in various organs and tissues are almost never found at present. In a number of works (B. L. Ospovat, 1963, etc.) it is stated that for hematogenous dissemination of actinomycosis, a breakthrough of a specific granuloma into the lumen of a blood vessel is sufficient. However, the data available in modern literature cast doubt on the absoluteness of this statement: even the germination of actinomycoma into the lumen of cytotec vena cava and the formation of a significant thrombus from specific granulations does not always cause hematogenous dissemination. Apparently, conditions are necessary under which hematogenous dissemination can occur.

Mike Brown, MPT, CSCS

Aaron Hertel, MPT, Cert. MDT

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In cases of accession of a purulent infection, necrosis of the cortical sections of the jaw may occur, followed by their sequestration (a picture of cortical osteomyelitis). This is an indication for surgical intervention - sequestrectomy. Generalized actinomycosis.

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The initial (primary) focus of actinomycosis can be localized in any organ or tissue of the patient's body.

Complications. The intensive development of connective tissue characteristic of actinomycosis can lead to cicatricial deformity of the organ involved in the process and disruption of its function (for example, compression of the ureters, intestinal lumen). A long-term focus of actinomycosis can undergo blastomatous transformation, leading to the development of amyloidosis of internal organs.

Diagnosis and differential diagnosis. Recognition of actinomycosis remains a difficult task: the frequency of misdiagnosis is high and causes late diagnosis, delays the start of rational treatment, and significantly lengthens its time.

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For the timely diagnosis of actinomycosis, a comprehensive examination of the patient is necessary, including clinical, radiological and laboratory research methods. Actinomycosis should be differentiated from processes caused by banal pyogenic flora, neoplasms, and tuberculosis. Actinomycosis of the appendix may mimic acute appendicitis. Appendectomy at the same time is quite justified.

Unlike an abscess caused by a banal pyogenic flora, the focus of actinomycosis does not undergo total purulent fusion, it tends to spread to the surrounding tissues; after opening a specific abscess, a fistula is revealed that goes deep into the tissues (except in cases of primary actinomycosis of the skin).

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