Actinomycetes grow well on sugar agar and Sabouraud's medium. The first colonies (lyrica) appear after 2-3 days. After - 10 - 14 days, bumpy or flat wrinkled macrocolonies grow. Based on the totality of biological properties, a pure culture is identified.
To identify the pathogen in fixed tissues or directly in drusen, the method of direct immunofluorescence is used. Identification of the sensitivity of pathogens to antibacterial drugs helps doctors choose adequate antibiotic therapy.
An allergic test with actinolysate is of secondary importance. Only positive or sharply positive results are taken into account. Weakly positive tests are often recorded in individuals with dental diseases and, first of all, with alveolar pyorrhea. Negative tests are often recorded in individuals with a sharply reduced immunity, which is often noted in HIV infection.cited patients.
Express diagnostic methods. The method of direct and indirect fluorescence is used to detect specific antibodies to actinomycetes and determine the type of pathogens present in druses. Genetic research is currently under development.
Actinomycosis should be distinguished from a number of diseases: The pulmonary form of actinomycosis should be distinguished from an abscess, neoplasms, deep mycoses of a different nature, and tuberculosis. The abdominal form of actinomycosis should be distinguished from appendicitis, peritonitis and other purulent diseases of the abdominal cavity. Bone lesions should be distinguished from purulent diseases of the musculoskeletal system. Actinomycosis of the skin should be distinguished from tuberculous lupus, scrofuloderma, gummous syphilides, malignant tumors and other deep mycoses.
In the photo, a histological preparation of an organ affected by actinomycetes. The inflammatory infiltrate consists mainly of neutrophils. Granules (drusen) consist of many threads of branched Gram-positive bacteria. The treatment of actinomycosis is complex and includes several complementary techniques: Etiotropic therapy. Surgery. Immunotherapy. Immunity boost. Hyposensitizing therapy. Physiotherapy.
Mandatory is the sanitation of organs that are presumably the entrance gate for infection: the oral cavity, nose, ear, throat, etc. Of the antibiotics, the drug of choice is benzylpenicillin. Tetracyclines, erythromycin, clindamycin, chloramphenicol, kanamycin, ristomycin, chloramphenicol, etc. are also prescribed. Antibacterial treatment is prescribed and carried out under medical supervision.
With the ineffectiveness of conservative therapy, surgical treatment is indicated, aimed at excision of the affected tissues, followed by drainage. With extensive suppuration in the lung tissue, a lobectomy is indicated.
In order to stimulate the immune system, the introduction of a specific preparation of actinolysate is practiced.
After Lyrica, the patient is subject to observation for 2 years. 1-2 courses of anti-relapse treatment are shown. In the absence of adequate treatment, the prognosis is serious. The death of patients with abdominal actinomycosis reaches 50%, with thoracic - 100%. If actinomycosis is detected in the early stages, the prognosis is favorable, it worsens significantly with actinomycosis of internal organs.