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Actinomycoses are sporadically occurring endogenous polymicrobial inflammatory processes, in which fermentative actinomycetes of the genera Actinomyces, Propionibacterium, or Bifidobacterium act as the principal pathogens. Difficulties in diagnosing the disease in a timely and reliable fashion have led clinicians and microbiologists to grossly underestimate its medical importance. Therefore, we evaluated microbiological and selected clinical data derived from 1997 culture-positive cases of human cervicofacial actinomycoses examined in our laboratories during 1972-1999. The causative actinomycetes belonged to at least 9 different species, among which Actinomyces israelii and Actinomyces gerencseriae predominated. The well-known predisposition of male patients to acquire the disease varied with age and appeared to be especially pronounced in patients aged 20-60 years, the highest incidence being found in female patients aged 11-40 years and in male patients aged 21-50 years. The relevant procedures necessary for diagnosing human actinomycoses reliably, as well as details of their complex etiology, are discussed.

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La actinomicosis cervicofacial es una enfermedad endógena no contagiosa, supurativa y generalmente localizada con tendencia a la fistulización. Sus agentes etiológicos son bacterias del género Actinomyces cuyo hábitat natural son zonas con baja tensión de oxígeno de la cavidad bucal. La causa desencadenante para que se produzca es el trauma quirúrgico accidental. Es considerada una enfermedad de la edad adulta, sin embargo nuestra experiencia nos permite asegurar que también se produce en la niñez, a partir de la presencia de dientes en la cavidad bucal. El objetivo de esta comunicación es presentar dos casos clínicos de niños derivados a la Cátedra de Microbiología de la FOUBA para realizar el diagnóstico microbiológico de actinomicosis (AU)

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A retrospective study of the incidence of cervicofacial actinomycosis in patients attending the Liverpool Dental Hospital from 1980-1983 was undertaken. A total of 86 patients were found which were divisable into three distinct presentations: acute painful swellings with a duration of less than 1 month; chronic long-standing infections, duration greater than 3 months; unsuspected microbiologically-proven actinomycotic lesions. A prospective study from 1983-1986 also was divisable into three similar types of presentations. The most common presentation in both parts of the study was acute painful swellings associated with soft tissue abscesses secondary to dental lesions. Clinicians dealing with acute dentally-associated swellings should consider the possibility of actinomycosis as a possible diagnosis.

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Actinomycosis was at one time a common diagnosis in this country. It still is fairly common in some parts of the world. As the numbers of antibiotics and indications for their use have increased, the disease has almost become a medical rarity in the United States. This fact might be thought a paradox in view of the universal presence of the actinomyces organisms in every human mouth. However, it is perhaps not well recognized that the actinomyces are true bacteria, and that they are particularly sensitive to most of the common antibacterials in current usage. These facts have combined to decrease the clinical frequency of the disease as well as effectively reduce the opportunity for securing a satisfactory specimen for laboratory culture in suspected cases. Actinomycosis can present in a variety of forms and may mimic other infections or even neoplasms. The clinical pattern of remission and exacerbation of symptoms occurring in parallel sequence with initiation and cessation of antibiotic administration is a phenomenon which should increase suspicion for actinomycosis in any of its manifestations.

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The clinical histories of 133 patients with cervicofacial actinomycosis, treated stationary in the period of 1948--1976, are interpreted in regard to patients age, treatment period and microbiological of histological proof. The opinions in literature about the frequency and a change of actinomycosis in the antibiotic era are discussed.

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Actinomycosis is often considered to be a rare disease in the oral region. A retrospective study of the Routine Diagnostic Services in Glasgow Dental Hospital revealed 39 cases in which actinomyces were detected, indicating that this organism is not infrequent in oral infections and may be seen in a variety of lesions.

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