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8th > Chapter 158 - Actinomycosis, nocardiosis, Actinomycetoma > Flashcards

Chapter 158 - Actinomycosis, nocardiosis, Actinomycetoma Flashcards

1
Q

Actinomyces is ___ and part of our nirmal (3)

A

Anaerobic
Respiratory
Intestinal
Genitourinary

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2
Q

Clumping of filamentous bacteria seen in infected living tissue often characteristic but not specific

A

Sulfur granule/grain

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3
Q

Most common causative agent of actinomycosis

A

A. Israelii

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4
Q

Actinomycosis is commonly seen in ___, ages ___ except for GU actinomycosis

A

Males, 20-60 years old

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5
Q

Actinomycosis should be suspected when dealing with 1 out of 3 features:

A
  1. Mass like inflammatory infiltrate of skin and subQ
  2. Sinus formation with drainage
  3. Relapsing or refractory clinica course after short therapy with antibiotics
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6
Q

Arrange from most frequent to less frequent:
Cervicofacial
Thoracic
abdominal

A

Cervicofacial 55%
Abdominal 20%
Thoracic 15-20%

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7
Q

MC sites of cervicofacial actinomycosis (3)

A
  1. Jaw angle, high cervical area (60%)
  2. Cheek (16%)
  3. Chin (13%)
    Rare: TMJ, retromandibular
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8
Q

Bone involvement is ___% in cervicofacial actinomycosis

A

10

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9
Q

Up to 26% will have chest wall involvement in thoracic actinomycosis termed as

A

Empyema necessitans

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10
Q

In 65% of abdominal actinomycosis, there is precipitating (2)

A

Appendicitis

Diverticulitis

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11
Q

IUd use longer than ___ years is considered a risk factor for Gu actinomycosis

A

2

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12
Q

Grains are commonly seen in this particular form of actinomycosis

A

Punch/Fist actinomycosis

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13
Q

In thoracic disease __ seems to predominate

A

A. Graevenitzii

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14
Q

True granuloma formation is common in actinomycosis.

True or False

A

False, rare

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15
Q

Best material for culture (3)

A

Purulent drainage
Tissue
Microscopic granules
nOT swav

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16
Q

Culture media of actinomycosis

A

Thioglycolate w/ 0.5 sterile rabbit serum at 35 C for 14 days

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17
Q

Stains for actinomycosis (4)

A

Brown Brenn
Gram
Giemsa
Gomori

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18
Q

Rim of eosinophilic material surrounding granules in tissue

A

Splendore Hoepplie phenomenon

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19
Q

Nocardia cannot be stained with Fite

True or False

A

False, actinomyces

20
Q

Eumycetoma granules stain positive with (2)

A

PAS

Gomori

21
Q

Treatment for actinomyces

A

PenG 18-24 M units IV for
30 days if cervicofacial
3 mos for pelvic or thoracic

22
Q

Risk factors for relapse or death (3)

A

Duration longer than 2 months
Lack of antibiotic therapy or surgery
Needle aspiration rather than open drainage or excision

23
Q

In nocardia, ___ infection is seen in immunocompetent and __ in immunocompromised.

A

Cutaneous

Pulmonary

24
Q

Primary skin disease is most commonly caused by ___; hematogenous dissemination by ____

A

N. Brasiliensis

N. Asteroides

25
Q

Nocardiosis occurs most commonly in __, presenting as __ most commonly

A

Males; pulmonary disease&raquo_space; skin

26
Q

MC form of cutaneous Nocardia infections

A

Sporotrichoid or lymphocutaneous forma

27
Q

Cellulitis form most commonly affects ___ while sporotrichoid form affects ___

A

LE

UE

28
Q

__ forms are able to survive inside macrophages due ti inhibition of phagosome lysosome in vitro

A

L

29
Q

Presence of (2) in Nocardia relates to virulence

A

Superoxide dismutase

Complex cell wall glycolipid

30
Q

Nocardia sps with high degree of resistance to 3rd gen cephalosporins

A

N. Farcinica

31
Q

High degree of dissemination amongst Nocardia sp

A

N. Pseudobrasiliensis

32
Q

Definitive diagnosis of Nocardia

A

Isolation of sp. in culture

33
Q

Pretreatment of Nocardia specimens with low pH ___ for 4 mins is required

A

KCl-HCl

34
Q

Matching type

  1. N. Asteroides
  2. N. Brasiliensis
  3. N. Otitidiscavarum

A. Salmon pink to orange
B. Orange
C. Pale

A

A
B
C

35
Q

Gold standard for ID of Nocardia sp

A

RNA sequencing on 16S rRNA

36
Q

Cornerstone of Tx for Nocardia except N. Otitidiscavarum

A

TMP SMX

(5-10mkday + 25-50mkday) BID-QID

37
Q

In America, MC etiology of actinomycetoma is

A

Nocardia brasiliensis

38
Q

Mycetoma triad (3)

A

Painless subQ mass
Sinus formation
Seropurulent discharge with grains

39
Q

Actinomycetoma mainly affects ___age ranging from ___ mc involving

A

M, 21-40 years old, LE

40
Q

Actinomycetoma caused by N. Brasiliensis is a very inflammatory process characterized by tumor like soft tissue swelling, deformity, and discharging sinus tracts with communicating channels that exudate pus (97%)

A

Tumefaction

41
Q

MC etiology of women with plantar involvement

A

A. Madurae

42
Q

Actiomycetoma without sinus tracts

A

Cryptic mycetoma

43
Q

Actinomycetoma characterized by Single or multiple small lesions observed mainly in children

A

Minimycetoma

44
Q

Risk factor for actinomycetoma

A

Walking barefoot in areas of high prevalence

45
Q

Purple granules with a cartographic shape and eosinophilic fringe are seen in

A

Actinomyces madurae

8th (28 decks)

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