9/30/2022

Actinomycetes are a family of bacteria that form

long branching filaments that resemble hyphae of
fungi.
They are Gram positive but some (Nocardia asteroides )
Actinomycetes are weakly acid fast.

Genera
1. Actinomyces - causes actinomycosis and mycetoma.
Dr. Mahfuza Nasrin
Associate. Professor
2. Nocardia- causes nocardiosis and mycetoma.
Microbiology

Pathogenesis and Pathology.

• Actinomyces are anaerobes.
Actinomyces israelii, and a few other species
cause actinomycosis and mycetoma.
• Morphology and Staining- Gram-positive
filamentous organism which show branching
filaments that resemble hyphae of fungi.
A.israelii is a commensal of mouth.
The endogenous infection occurs due to local trauma
such as broken jaw or dental extraction or after
appendicectomy.
It causes actinomycosis, a chronic suppurative
inflammatory disease, which is a abscess with draining
sinus tract and sulpher granules in pus.
'sulphur granules' which are composed of
microcolonies of bacteria embedded in tissue
elements like macrophages, other tissue cells, fibrin.

Clinical Findings

The typical lesion of actinomycosis Three common forms on Site of Involvement:

appears as a hard, non tender
swelling that develops slowly and
eventually drains pus through sinus 1. Facio-cervical actinomycosis,
tracts . 2. Thoracic actionomycosis,
sulfur granules are hard, yellow
3. Abdominal actinomycosis.
granules composed of a mass of
filaments are formed in pus. Secondary lesions may occur in lung (pulmonary
actinomycosis),liver etc. by haematogenous spread.

1
 9/30/2022

B. Laboratory Methods:
Laboratory Diagnosis
1. Microscopic Examination- Smear are made with crushed
A. Specimens: Sulphur granules between two slides and stained by:
(a) Gram Staining- Gram positive branching rods.
(1) Pus with 'sulphur granules’ from lesions.Granules
are washed with sterile saline .
(2)Tissue biopsy. 2. Culture- Material is inoculated into thioglycolate media or
brain-heart infusion media in anaerobic condition.

Antimicrobial Treatment
Penicillin is administered for prolonged period coupled with
surgical drainage.

NOCARDIA Cultural characteristics.

-Nocardia asteroides and Nocardia brasiliensis are aerobic
organisms that are found worldwide in soil and water.
- They cause nocardiosis and mycetoma.
Morphology and Staining.
-Nocardia species are Gram- positive,
-catalase positive
- weekly acid-fast.
Aerobes. Nocardia species grow on various media.
Pigment varies from white to red to orange depending
on species.
Pathogenesis and Pathology.
-Nocardiosis is an opportunistic infection.
-It may begin as pulmonary infectionand may progress
to form abscesses and sinus tracts.
-In immunocompromised persons, abscesses may
develop in brain or kidneys.

Laboratory Diagnosis Mycetoma

A. Specimens : Sputum, pus, spinal fluid and biopsy
• Mycetoma (Madura foot) are tumors caused by
material. actonomycetes and Fungi that develop in
B. Laboratory Method : tissues in the form of mycelium.
1. Microscopic examination : Mycetoma are two types.
(i) Gram-positive bacilli with branching filaments or rods 1)Actinomycotic caused by Actinomycetes,Nocardia
(ii) Weekly acid-fast. and Streptomyces.(Actinomycetoma).
2. Culture 2)Eumycotic group caused by Fungus(Eumycetoma)
-BHI agar
-Buffered charcoal yeast extract agar.

2
 9/30/2022

Clinical features LABORATORY DIAGNOSIS

• Chronic granulomatous lesion with multiple
discharging sinuses. The discharge will contain
granules.
• Collection of specimen:
• Serosanguinous fluid discharged by a draining sinus.
If granules present picked up by a sterile needle and
washed repeatedly with sterile saline.

Direct Microscopic Examination:

Granules are pressed between two slides and then
Gram stain and Modified Z-N stain is done.

Aetiologic agents of Eumycetoma

• Madurella mycetomatis.
• Madurella grisea.
• Acremonium falciforme.