Friduss M E, Maceri D R
Department of Otolaryngology, Henry Ford Hospital, Detroit, MI 48202.
Henry Ford Hosp Med J. 1990;38(1):28-32.
Actinomycotic infections, once common in humans and cattle, are now rare causes of disease in man. This general group of organisms belongs taxonomically between the true bacteria and the fungi; however, the organisms behave clinically like true anaerobes. The organism, although phagocytized by the host cells, is not killed. Therefore, it is defined as a facultative intracellular parasite of the host. The protean manifestations of actinomycotic infections often mimic infectious processes, such as osteomyelitis or granulomatous disease, as well as neoplasia. It is therefore important for the surgeon to include actinomycosis in the differential diagnosis of cervicofacial masses in children as well as in adults. Being an anaerobe, the organism is difficult to culture and the diagnosis must be considered at the time of biopsy of a cervicofacial mass or when culturing a sinus tract. A case of a 12-year-old girl seen at Children's Hospital of Los Angeles prompted the review of our experience with this disease. In this child, actinomycosis presented as an expansile mass in the mandible. From 1956 to 1986, five children were treated for cervicofacial actinomycosis. Detailed case analysis, pathophysiology, clinical characteristics, and current treatment recommendations are presented.
放线菌感染曾在人类和牛中很常见，如今在人类中已成为罕见的致病原因。这一类微生物在分类学上介于真细菌和真菌之间；然而，这些微生物在临床上表现得像真正的厌氧菌。该微生物虽然会被宿主细胞吞噬，但不会被杀死。因此，它被定义为宿主的兼性细胞内寄生虫。放线菌感染的多种表现常常酷似感染性疾病过程，如骨髓炎或肉芽肿性疾病，以及肿瘤。因此，对于外科医生来说，在儿童和成人颌面部肿块的鉴别诊断中考虑放线菌病很重要。作为厌氧菌，该微生物很难培养，在对颌面部肿块进行活检或对窦道进行培养时必须考虑到诊断。洛杉矶儿童医院收治的一名12岁女孩的病例促使我们回顾了我们在这种疾病方面的经验。在这个孩子身上，放线菌病表现为下颌骨的一个扩展性肿块。从1956年到1986年，有5名儿童接受了颌面部放线菌病的治疗。本文介绍了详细的病例分析、病理生理学、临床特征以及当前的治疗建议。
