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.
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.
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.
Advocate + Educate + Love + Accept
At Atlanta Autism Center we provide comprehensive, family-centered diagnostic and therapy services for children with autism spectrum disorder. Our ASD services include initial diagnosis, ongoing management, help with communication and activities of daily life, medication management, ABA, physical, occupational, speech, feeding therapies, and referral to specialty care as needed.
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.
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 .
Call Atlanta Autism Center Now
The best results are obtained by a combination of etiotropic therapy (antibiotics) and immunotherapy (actinolysate). In the cervico-maxillofacial form, phenoxymethylpenicillin is administered orally at a dose of 2 g / day and with a course duration of at least 6 weeks.
Serological diagnosis Actinomycotic infection does not necessarily stimulate a humoral immune response, which can be detected by available laboratory methods. However, none of the methods used, with a wide variety of antigens used, did not provide satisfactory results due to problems with sensitivity and specificity (Holmberg, Nord and Wadström 1975, Holmberg 1981, Persson and Holmberg 1985).
Molecular methods, such as genetic studies or allopurinol chain reactions (PCR), are currently being developed and may in the future be able to allow faster diagnosis of actinomycosis.
This is necessary to reliably identify the differences between fermenting actinomycetes and morphologically similar contaminants obtained from the mucous membranes of the patient, as well as similar aerobic actinomycetes of the genera Nocardia, Actinomadura and Streptomyces. A detailed bacteriological analysis of the associated microflora may also be helpful in selecting appropriate antibiotic therapy.
Meet Our Team
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.
Since the removal of plates from an anaerobic environment usually stops the further growth of microorganisms that need a long incubation without changing the anaerobic conditions.
If anaerobic flasks or plates are used, it is advisable to inoculate two or three media at the same time to examine them for actinomycete growth after 3, 7 and 14 days.
Cultures can be examined every 2-3 days without altering anaerobic conditions if the method of Fortner (1928) is used to obtain a low oxygen potential.
Culture diagnosis To obtain reliable results, it is advisable to use clear media so that the plates can be carefully examined for the characteristic filamentous colonies, and cultured for at least 14 days.