To the issue of diagnosis of actinomycosis of the oral cavity

Abstract

Aim: Discussion of the possibilities of diagnosing actinomycosis of the oral cavity.

Materals and meshods. After the clinical examination, laboratory tests were carried out, which included histological and microbiological studies affected tissue of the tongue.

Results. Cytological and pathohistological examination revealed no signs of the oncological process. However, specific changes in the tissue characteristic of actinomycosis. According to the results of a microbiological study, S.pyogenes was detected in the amount of 104 CFU/ml and Candida albicans in the amount of 105/ml. The growth of colonies typical for actinomycetes was found on the mineral medium. Microscopic examination of the biomass from the colonies confirmed that the isolated culture belonged to Actinomyces.

Conclusion. The diagnosis of actinomycosis remains a difficult issue and requires, firstly, the exclusion of an oncological process. The use of pathogistological research, which is the «gold standard» for the diagnosis of actinomycosis, makes it possible to solve the problem. However, in doubtful cases, the percentage of which can be significant, microbiological diagnosis is also important. The decision regarding treatment was made considering all factors. In our clinical case, the causative agent of the infectious process turned out to be a presumably low-virulence strain of Actinomyces israelii in association with streptococcus, Antimicrobial therapy was directed to the treatment of both actinomycosis and antistreptococcal treatment. The use of ceftriaxone and penicillin drugs was effective. Fluconazole was also prescribed to prevent candidiasis.