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Organism
- Anaerobic gram positive rods
- Branch at acute angles and show irregular staining
- Sulfur granule
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Epidemiology
- Commensal flora in GI tract
- Highly adpated to mucosal surfaces
- Produce disease when enter low oxygen tissues (i.e. tooth extraction, MVA)
- Growth in microcolonies
- mixed infections
- Inflammatory sinuses which discharge to surface
- Free bacteria rarely seen in stains
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Manifestations
- Cervicofacial - most common - poor dental hygiene, toot extraction
- Thoracic - aspiration or trauma
- Firm, fibrous mass - can be mistaken for cancer
- localized endometriosis with IUD
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Diagnosis
- Clinical - nature of lesion, slow course, and history of trauma or condition for Actinomyces
- Sulfur granules show dense gram positive center
- Biopsy
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Treatment
- Penicillin G
- High dose for 4-6 weeks
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