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Microscopic examination When drusen are present, this makes it possible to quickly and relatively reliably make a preliminary diagnosis after examination at low magnification (d 100) of an actinomycotic granule placed under a coverslip and with a drop of 1% solution of methylene blue.

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Actinomycotic drusen appear as cauliflower-like particles with an unstained center and a blue periphery, in which leukocytes and short filaments, sometimes with clubs, radiate from the center of the granule.

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Gram-stained smears obtained by squeezing pellets between two slides show filamentous, branching, Gram-positive structures that represent pathogenic actinomycetes, as well as a variety of zyloprim pills and Gram-positive bacteria that indicate the presence of concomitant microorganisms. The presence of these bacteria is necessary to distinguish actinomycotic drusen from granules formed by various aerobic actinomycetes (Nocardia, Actinomadura, Streptomyces), which never contain an accompanying microflora.

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and allopurinol

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When layering a secondary infection (staphylococcus, anaerobic microflora), long courses of allopurinol or antibiotics of the tetracycline group are prescribed, with anaerobic infection - metronidazole. For immunotherapy, actinolysate can be administered subcutaneously or intradermally, as well as intramuscularly. Under the skin and intramuscularly, 3 ml of actinolysate is administered 2 times a week.

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You can also prescribe tetracycline in large doses (0.75 g 4 times a day for 4 weeks or 3 g per day only for the first 10 days, and then 0.5 g 4 times a day for the next 18 days) . Erythromycin is prescribed 0.3 g 4 times a day for 6 weeks. In abdominal forms and with actinomycosis of the lungs, large doses of benzylpenicillin (10,000,000 IU / day or more) are prescribed intravenously for 1-1.5 months, followed by a transition to phenoxy-methylpenicillin in a daily dose of 2-5 g for 2-5 months .


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Preliminary culture results are obtained after 2-3 days, when the characteristic arachnid microcolonies of A. israelii, A. gerencseriae or P. propionicum can be seen under the microscope. Confirmation of preliminary microscopic or early culture diagnoses by unambiguous identification of the pathogenic variety of actinomycetes can take 14 days or more.

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