Actinomyces and NocardiaActinomyces and Nocardia

Chapter 24Chapter 24

教学大纲教学大纲掌握：放线菌属的形态染色、硫磺掌握：放线菌属的形态染色、硫磺样颗粒。样颗粒。

熟悉：放线菌的致病性、与龋齿和熟悉：放线菌的致病性、与龋齿和牙周炎关系。牙周炎关系。

ActinomycesActinomyces

A. israeli,A. israeli, A. naeslundii; A. naeslundii; GG＋＋ AnaerobicAnaerobic, form filament, , form filament,

Exhibit true branchingExhibit true branching Related to decay tooth and Related to decay tooth and

peridentitis peridentitis

Clinical specimens : Actinomycosis-pusClinical specimens : Actinomycosis-pus

Sulfur granule is visibleSulfur granule is visible

Sections or Sections or tabletting : tabletting : chrysanthemum-like chrysanthemum-like appearanceappearance

Opportunist organism, component of Opportunist organism, component of oral flora (endogenous)oral flora (endogenous)

Take advantage of injury toTake advantage of injury to penetrate penetrate mucosal barriersmucosal barriers TraumaTrauma SurgerySurgery

ActinomycosisActinomycosis A chronic suppurative and A chronic suppurative and

granulomatous disease of the granulomatous disease of the cervico-cervico-facial, thoracic or abdominalfacial, thoracic or abdominal areas areas

Pus contains "Sulfur Granules"Pus contains "Sulfur Granules" yellow – orangeyellow – orange Composed of mineralized “mycelial” massComposed of mineralized “mycelial” mass Colony of bacteriaColony of bacteria

  

sulfur granulesulfur granule

Form Form burrowing sinusburrowing sinus tracts to skin or tracts to skin or mucus membranes——mucus membranes——

Discharge purulent materialDischarge purulent material

Pulmonary Pulmonary ActinomycosisActinomycosis

NocardiosisNocardiosis

G+, rod G+, rod ，， weakly weakly acid-fastacid-fast N. asteroides; N. brasiliensisN. asteroides; N. brasiliensis Subcutaneous infections, pulmonary Subcutaneous infections, pulmonary

infections, and brain abscessesinfections, and brain abscesses

nocardianocardia

Subcutaneous infectionsSubcutaneous infections

pulmonary infectionspulmonary infections

MycetomaMycetoma((足分枝菌病）足分枝菌病）

Features of actinomycetesFeatures of actinomycetesActinomyces:Actinomyces: branching bacilli, branching bacilli,

non-acid fastness, anaerobic, non-acid fastness, anaerobic,

oral ,intestinal ,oral ,intestinal ,endogenous floraendogenous flora,,

chronic cellulitis, draining sinuseschronic cellulitis, draining sinuses

Nocardia: branching bacilli ,Nocardia: branching bacilli ,weak acid weak acid

fastfast, aerobic, , aerobic, soil (exogenoussoil (exogenous ) , ) ,

pseumonia ,skin pustules ,pseumonia ,skin pustules ,

brain abscess brain abscess

summarysummary

Actinomyces :stain ,clinical Actinomyces :stain ,clinical feature, diseasefeature, disease

Nocardia: stain, diseaseNocardia: stain, disease