Boyanova Lyudmila, Kolarov Rossen, Mateva Lyudmila, Markovska Rumyana, Mitov Ivan
Department of Medical Microbiology, Medical University of Sofia, Bulgaria.
Future Microbiol. 2015;10(4):613-28. doi: 10.2217/fmb.14.130.
Actinomycosis is a rare subacute or chronic, endogenous infection mainly by Actinomyces species, showing low virulence through fimbriae and biofilms. Cervicofacial, thoracic, abdominal, pelvic and sometimes cerebral, laryngeal, urinary and other regions can be affected. Actinomycosis mimics other diseases, often malignancy. Disease risk in immunocompromised subjects needs clarification. Diagnosis is often delayed and 'sulfur granules' are helpful but nonspecific. Culture requires immediate specimen transport and prolonged anaerobic incubation. Imaging, histology, cytology, matrix-assisted laser desorption ionization time-of-flight mass spectrometry and molecular methods improve the diagnosis. Actinomycetes are β-lactam susceptible, occasionally resistant. Treatment includes surgery and/or long-term parenteral then oral antibiotics, but some 1-4-week regimens or oral therapy alone were curative. For prophylaxis, oral hygiene and regular intrauterine device replacement are important.
放线菌病是一种罕见的亚急性或慢性内源性感染，主要由放线菌属引起，通过菌毛和生物膜表现出低毒力。可累及颈面部、胸部、腹部、盆腔，有时也可累及脑部、喉部、泌尿系统等其他部位。放线菌病常与其他疾病相似，尤其是恶性肿瘤。免疫功能低下患者的患病风险尚需明确。诊断往往延迟，“硫磺颗粒”虽有帮助但缺乏特异性。培养需要立即运送标本并进行长时间的厌氧培养。影像学、组织学、细胞学、基质辅助激光解吸电离飞行时间质谱和分子方法有助于诊断。放线菌对β-内酰胺类药物敏感，但偶尔也有耐药情况。治疗包括手术和/或长期肠外给药后口服抗生素，但一些1 - 4周的治疗方案或单独口服治疗也可治愈。对于预防而言，保持口腔卫生和定期更换宫内节育器很重要。
