A ctinomycosis is an infection caused by an anaerobic bacterium, Actinomyces sp., composed of thin branching fibres, akin to the hyphae of fungi, but much thinner in width. It is a commensal in the mouth and palatine tonsil. In the latter it may be seen normally as large Gram-positive masses of hyphae within the crypts, without any apparent pathological reaction apart from a few attached neutrophils. The commonest location for active infection by the organism is the immediate site of lymphatic drainage of the above, the anterior triangle of the neck, where the infection is manifested as an inflamed swelling with sinuses. Diagnosis is made by detection and microscopy of sulphur granules in the pus from the sinuses, biopsy of the lesion or prolonged anaerobic culture for the organism (see Chapter 30).
KeywordsStratification Bran Noma Actinomyces
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