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Diagnosis of actinomycosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

Reference:

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