Actinomycosis Pathophysiology and Hyperbaric Effects

Actinomycosis, a bacterial infection characterized by chronic inflammatory induration and sinus formation, presents clinical challenges. First, the infection eludes diagnosis because etiologic agents are bacteria and not fungi, a fact not yet well known. Second, clinicians must employ special anaerobic techniques to culture the causative micro-organisms. Actinomyces are indigenous to the oral and intestinal microflora. Therefore, culture of the micro-organism from these sites does not establish the diagnosis by itself. Actinomycotic lesions frequently involve other bacteria. Unfortunately, the presence of multiple bacterial organisms makes the primary isolation of Actinomyces more difficult. Because the micro-organisms involved are exquisitely sensitive to penicillin and other broad spectrum antibiotics, empiric antimicrobial therapy may mask clinical manifestations.