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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
Section 3. Summaries of Infectious Diseases
Actinomycosis
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: The 3 major anatomic types of disease are cervicofacial, thoracic, and abdominal. Cervicofacial lesions are the most common and often occur after tooth extraction, oral surgery, or facial trauma or are associated with carious teeth. Localized pain and induration progress to "woody hard" nodular lesions that can be complicated by draining sinus tracts that usually are located at the angle of the jaw or in the submandibular region. The infection usually spreads by direct invasion of adjacent tissues. Infection also may contribute to chronic obstructive tonsillitis. Thoracic disease most commonly is secondary to aspiration of oropharyngeal secretions and occurs rarely after esophageal disruption secondary to surgery or nonpenetrating trauma or may be an extension of cervicofacial infection. Disease manifests as pneumonia, which can be complicated by abscesses, empyema, and rarely, pleurodermal sinuses. Focal or multifocal
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