diagnosis of actinomycosis
Last reviewed 01/2018
diagnosis
Making the diagnosis of actinomycosis is difficult. It should be suspected in patients with the following clinical 'warning signs'
- indolent course
- chronicity
- mass-like features
- development of sinus tracts (which can heal and re-form)
- progression through tissue planes
- refractory or relapsing infection after short course of antibiotics
A definitive diagnosis depends on isolating the organism from a clinical specimen.
Investigations which are useful in actinomycosis include:
- blood test - usually non specific, may have anaemia, mild leucocytosis, raised ESR and CRP and alkaline phosphatase (in hepatic actinomycosis)
- histopatholgy - presence of gram positive filamentous organisms and sulphur granules on histological examination is strongly supportive of a diagnosis of actinomycosis
- microbiology - direct isolation of the organism (either from a clinical specimen or from 'sulphur granules) provides a definitive diagnosis
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