Microbiological and Clinical Aspects of Cervicofacial Actinomyces Infections: An Overview

Abstract

Similarly to other non-spore-forming Gram-positive anaerobes, members of the Actinomyces genus are important saprophytic constituents of the normal microbiota of humans. Actinomyces infections are considered to be rare, with cervicofacial infections (also known as ‘lumpy jaw syndrome’) being the most prevalent type in the clinical practice. Actinomycoses are characterized by a slowly progressing (indolent) infection, with non-specific symptoms, and additionally, the clinical presentation of the signs/symptoms can mimic other pathologies, such as solid tumors, active Mycobacterium tuberculosis infections, nocardiosis, fungal infections, infarctions, and so on. The clinical diagnosis of actinomycosis may be difficult due to its non-specific symptoms and the fastidious, slow-growing nature of the pathogens, requiring an anaerobic atmosphere for primary isolation. Based on 111 references, the aim of this review is to summarize current advances regarding the clinical features, diagnostics, and therapy of cervicofacial Actinomyces infections and act as a paper for dentistry specialists, other physicians, and clinical microbiologists.

Diagnosis and Management of Cervicofacial Actinomycosis: Lessons from Two Distinct Clinical Cases

“…Infiltration of Actinomyces spp. through damaged mucosal surfaces (caused by medical interventions, trauma, immunosuppression, or cancer) have been described as a principal factor for the development of the disease [8,18]. These infections mainly affect patients between 20 to 60 years of age, with a peak in incidence around 40 to 50 years; developments in hygiene practices and the use of prophylactic antibiotic therapy following dental procedures had a significant role in curbing the prevalence of actinomycosis; however, an increase in their frequency (proportionate with the increase in the number of immunosuppressed patients) in the last two decades is worrisome [2,3,19].…”

“…In addition, the clinical presentation of individual infections is myriad, further complicating diagnostic processes. Based on the affected anatomical region, these infections may be divided into cervicofacial, abdominal, thoracic, pelvic, and cutaneous actinomycoses [2,8]. Cervicofacial Actinomyces infections (including presentations with central nervous system involvement), also called as "lumpy jaw syndrome", are the most common type, accounting for 40%-60% of cases overall; the upper and lower mandibles (50%), the cheeks (10%-15%), and the chin (10%-15%) are most frequently affected [8,9].…”

“…Forty-nine different species have been described in the Actinomyces genus, out of which 27 species have been implicated as causative agents in human infections: in cervicofacial actinomycosis, A. israelii, A. odontolyticus, and A. meyeri are most frequently implicated (>90% of cases); nevertheless, other species, such as A. dentalis, A. hominis, A. oris, A. pyogenes, and A. viscous, are also relevant cervicofacial pathogens [8,10]. Cervicofacial actinomycosis was reported more frequently in patients living in rural areas, compared to people living in urban environments (the observed prevalence was 10:1); this difference was usually attributed to poor hygiene, neglected health status, low socioeconomic status and close contact with animals [11].…”

Extraintestinal Clostridioides difficile Infections: Epidemiology in a University Hospital in Hungary and Review of the Literature

“…Cd strains were isolated from extraintestinal sites using conventional, routine methods in anaerobic bacteriology, according to standard descriptions [49,50]. These methods were not specifically designed to detect Cd strains only, but rather to detect all of the culturable anaerobic bacteria in these samples [51]. Sample preparation and microbiological culture were carried out according to the routine microbiological practice [49,50].…”

Taxonomy and nomenclature of bacteria with clinical and scientific importance: current concepts for pharmacists and pharmaceutical scientists

“…The restriction of the genus Bacteroides to B. fragilis and related species has led to the relclassification and transfer of numerous species to the genera Prevotella and Porphyromonas (based on pigmentation, bile-sensitivity and saccharolytic properties) and the introduction of novel genera [61][62][63][64]. Marked changes have also occured in the field of Gram-positive anaerobic cocci with the introduction of novel species, such as Finegoldia, Parvimonas and Peptinophilus, based on phylogenetic analysis [16,[65][66]. Eubacterium species were also subject to taxonomic revisions, leading to the introduction of novel genera, such as Slackia, Pseudoramibacter, Mogibacterium, Eggerthella and Cryptobacterium [16,65].…”