Maxillofacial actinomycosis

Introduction

Introduction to maxillofacial actinomycosis

Actinomycosis is a chronic specific inflammation. The face and neck are one of the most prevalent sites of actinomycosis, and may also involve the parotid gland, but it is rare.

basic knowledge

The proportion of illness: 0.001%

Susceptible people: good for men aged 20 to 50

Mode of infection: non-infectious

Complications: osteomyelitis

Pathogen

Causes of maxillofacial actinomycosis

The most common pathogen in the human body is actinomyces israeli, which is anaerobic, Gram-positive, non-acid-resistant. Many people have this bacterium in the mouth, which can cause tissue due to inflammation. Hypoxia and reduced resistance are conducive to the growth and spread of actinomycetes and can invade the parotid gland.

Prevention

Prevention of maxillofacial actinomycosis

Because the majority of actinomycosis is endogenous infection, the large number of applications of immunosuppressants is often an important predisposing factor, so try to avoid the large number of applications of immunosuppressants.

When the body's resistance is reduced, it causes actinomycosis, and strengthening the body to improve immunity has great significance for actinomycosis.

When extracting teeth and purulent bacterial infections, actively perform sterilization work to prevent actinomycetes from invading tissues.

Complication

Complications of maxillofacial actinomycosis Complications osteomyelitis

Spread along the connective tissue gap, and occasionally bloody dissemination, the disease can be delayed for several months to several years, after a long illness, often cause the jaw to be involved, causing osteomyelitis, lesions of the maxilla, can be further extended to the eyelids , skull and meninges, mandibular lesions, can form the parotid fistula or spread down to the neck and chest.

Symptom

Symptoms of actinomy of the maxillofacial region Common symptoms Submandibular gland pain, tenderness, submandibular lymph nodes, tenderness, abscess

Mainly rely on clinical manifestations and bacteriological examination, if the early clinical can not be diagnosed, if necessary, can do biopsy.

Actinomy cotis granules or sulphur granules, which are composed of bacteria and hyphae, are light yellow when invading tissue The diameter can reach hundreds of micrometers. Under the microscope, the basophilic irregular lobular body is seen. The central part is uniform, the radial part of the filament is branched at the edge, and the colloidal sheath is often formed at the top of the filament to form a glassy scorpion. Surrounded by a large number of neutral polynuclear leukocytes, the periphery is epithelial-like cells, giant cells, eosinophils and plasma cells, and the outermost layer is dense fibrous connective tissue.

The age of onset is mainly 20 to 50 years old, and men are often twice as many as women.

The early symptoms of the parotid gland showed a painless small mass, which gradually increased. The gland was swollen, the tissue was hard, and there was an indentation. The exudate gland duct was not secreted and the tumor was inactive. There is an abscess formation, pain or heat, the surface of the skin is dark red or purple, the plate is hard, no obvious boundary with the surrounding normal tissue, the inflammation continues to develop, the surface skin becomes soft, the abscess gradually collapses, and the outflow is yellowish and sticky. Pus, eye or pus staining examination, can be found "sulphur particles", inflammatory infiltrates after rupture of pus, soon formed new nodules and abscess around them, abscesses communicate with each other, forming The road is transferred to the chronic phase, and the sputum has irregular granulation tissue. If it is accompanied by a suppurative infection, it can also be acutely attacked, and the symptoms of acute cellulitis appear. The body temperature is as high as 38.5~39 °C. Unlike general inflammation, although the inflammation can be improved by incision, the local plate-like hard swelling of actinomycosis does not completely subside, leaving a purple-red atrophic scar after healing.

Examine

Examination of maxillofacial actinomycosis

Bacteriology examination, if the early clinical diagnosis can not be confirmed, if necessary, biopsy can be done, and the pure culture of actinomycetes can be isolated in the caries, tonsil crypts and the like.

Diagnosis

Diagnosis and diagnosis of maxillofacial actinomycosis

Differentiation from cervical lymphatic tuberculosis: After the cervical lymphatic tuberculosis collapses to form the fistula, the pus outflow is thinner, there is no sulphur-colored particles, and the lesions are arranged in a strip-like shape.