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For analysis with the aim of bacteriological confirmation of actinomycosis, biological material is used - this is: purulent discharge from fistulous passages; sputum (bronchial secret); biopsy material (in particular, from infiltrates).

To avoid erroneous diagnosis during the sampling of biological material, care must be taken not to contaminate the samples with congenital actinomycotic saprophytic microflora from the mucous membranes.

For this purpose, biological material (pus or tissue) in all possible cases is obtained: with percutaneous puncture; for diagnosing the thoracic form of actinomycosis - through transtracheal puncture.

Such punctures, bypassing congenital foci of cialis pills, are often the only way to obtain satisfactory samples of biological material forI am a diagnostic study.

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But it should be remembered that when using a biomaterial taken through transtracheal puncture, the diagnosis can also be unreliable, because the contents of the oral cavity, in which actinomycetes (both saprophytic and pathogenic) live, can enter order tadalafil.

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Actinomycetes are characterized by the ability to ferment, therefore they are easily oxidized (generic cialis). This means that it is necessary to transport the biological material after sampling to the bacteriological laboratory promptly, until it has undergone changes that can distort the results of the study and affect the diagnosis. If, nevertheless, long-term transportation is to be carried out, then it is necessary to use special media designed for transportation - by the type of Stewart's medium.


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The presence of drusen allows a preliminary diagnosis of actinomycosis to be made. They can be identified by examining under a microscope an actinomycotic granule placed on a coverslip with the addition of methylene blue dye. Antimycotic drusen are visualized as particles in the form of cauliflower, in which: the center is not painted; blue colored periphery.

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In these particles, leukocytes and mycelial filaments (in some cases with characteristic flasks painted in pink) are visible, which diverge from the center of the granule to its periphery. The benefit of microbiological research is that, in addition to actinomycetes, concomitant microflora is determined in the smear, so that concomitant infectious diseases can be correctly assessed.

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It is possible to isolate the culture of the radiant fungus by sowing the material on the so-called Saburov's medium.

When sowing crops, the first results are obtained in 2-3 days. In these terms, under a microscope, one can visualize the characteristic, spider-like microcolonies of Actinomyces israelii or Actinomyces gerencseriae.

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When determining different types of actinomycetes in a granule, the detection of specific antibodies, which is carried out using immunofluorescence, will help: This method allows you to determine different types of pathogens even without sowing crops.

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In some cases, for the purpose of diagnosis, an intradermal form with actinolysate is used (it is positive in 80% of all patients). In this case, only positive and sharply positive results should be taken into account - weakly positive results are often observed in patients of dental clinics (for example, with alveolar pyorrhea, manifested by the release of pus from the alveoli). On the other hand, a negative test does not mean the absence of actinomycosis.

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It is defined by: patients suffering from severe forms of this disease; the negative result of the test is explained by a significant and abruptly onset inhibition of cellular immunity; HIV-infected (in this case, a negative result will always be observed).

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In many cases, actinomycosis, developing rapidly, requires detailing in a short time. For the sake of faster diagnosis, molecular methods are now being developed, such as: genetic research; polymerase chain reaction (PCR).

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In some cases, the diagnosis is complicated due to the fact that: clinical symptoms are more characteristic of other diseases than for actinomycosis; histological (tissue examination) and serological (determination of antibodies) studies are low specific and low sensitive. In other words, they can be positive not only with actinomycosis, but also with other diseases - on the other hand, with actinomycosis they give rather weak results, and this makes one doubt that the disease is provoked by the radiant fungus.


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Detection of drusen is not a 100% accurate method for diagnosing actinomycosis: drusen contained only 25% of samples isolated from fistulas, their absence did not mean the absence of actinomycosis, which in these cases was confirmed using other diagnostic methods.


Instrumental diagnostic methods, with which you can determine the presence of abscesses, act as auxiliary, because the detection of abscesses does not mean that they are of actinomycosis origin. On the other hand, instrumental methods can be an important help in diagnosis if, due to anatomical specifics, it is difficult to take pus or take a tissue biopsy.


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So, with actinomycosis of the central nervous system, computed tomography with contrast is performed, while abscesses are visualized in the form of foci with the following characteristics: round or irregular shape; with reduced density; surrounded by shadows in the form of wide rings.

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Actinomycosis of the lungs must be differentiated from: lung tumors; abscesses of the chest cavity; other mycoses (primarily aspergillosis, nocardiosis, histoplasmosis - previously rare, now more common diseases); tuberculosis of the lungs.


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Abdominal actinomycosis must be distinguished from surgical diseases: acute appendicitis; appendicular abscess; local peritonitis; diffuse peritonitis.



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etiotropic therapy - that is, aimed at the cause of the disease (antibacterial agents); immunotherapy.

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