Actinomycosis

yeah hi my dear witness and I hope you're giving your best shot for this microbiology now I'm going to discuss about act no mycosis indeed with our mind map so already I have given lots of mind maps for most of the bacteria on your group and I hope you're doing with the mind maps okay so the second and most important thing for microbiology particularly bacteria virus fungus and parasitoids is the proper mind maps and a proper nodes with your handwriting so this nodes can be used for further rounds of revision and particularly in the last one month or one and half month of the preparation which is the key or heart of the preparation okay so revision can be done when your stuff is properly organized with your notes so straight away I'm going with my mind map for this bacterium first of all the first important point to be added please most of the people they consider these organisms as transitional forms or the transfer forms or organisms would stand in between the bacteria and the fungus okay they stand in between they they're considered as the transformation from a bacteria to the fungus and of course it is a gram positive non sporulating non motile no organisms no extra organisms two organs to move non capsulated not acid fast and the two important bacteria are this just making out most of your questions will move around these two back here and these are normally present in your mouth intestine Brezina as a conscious and the mode of the mode of entry of these organisms is by the by the breakdown of the disturbance or or the crack or the basically the entry of these organisms into the body is by breaking the mucosal barrier in all these areas that is a mouth sorry that is a mouth intestine and the Vezina and basically the etiology in most of the cases can be a trauma a foreign body or a poor oral hygiene and most of your case description questions related to this they can give a description of recently recently extraction extraction of trauma trauma to that of the mandible or recent extraction of impaction or the most common histories are given regularly for this infection these are considered as endogenous infections okay you can see the sulfur granules ok-sun red ray like okay so it's the most common picture based description of this particular bacteria so next comes is the clinical features of this and most commonly seen in ten to thirty years of age you can consider this as a chronic granulomatous infection and you can see injury rates well and you can see clear in generated swelling at the angle of the mandible okay so your questions in your general path even in your general path this was the most commonly asked question which was chronic granulomatous infection you can go for that as actinomycosis and the discharge contains the sulfur granules most of them they give a beautiful description based question or they can simply give this diagram and they can tell upon upon the examination of the specimen or the biopsy we can clearly clearly see a sulphur granules you can directly go for acne or mycosis as the answer so coming to the clinical types and few textbooks they give three clinical types but there are few textbooks giving it as a for clinical types okay the clinical types goes as following the one is eros serviço facial which is the most common again this is the most commonly asked question or a cervical facial is the most common and the most common occurence area of this actinomycosis in the oral cervical facial is the angle of the mandible okay so I mean questions commonly asked what a slump beach' okay lumping ja rule and pizza okay the answer is actinomycosis okay so they can give a description based question this is the most common at the angle of the mandible that is the auto cervical fascia so the next types goes the type two is thoracic thoracic is mainly concerned with the lesion in the lungs and the pleura and affecting the pericardium okay all these areas are involved in the case of the thoracic type and the next third one is abdominal type in which the abdominal wall is most commonly affected okay and following the last one that is the pelvic type which is most commonly seen with with with a woman or people who are using intrabrand devices and basically you can see the abscess around around the bone and the soft tissue and the very important peculiar feature of this act no mycosis and the question is chronic draining sinuses okay so they can ask you like sulfur granules is a common finding apart from that multiple okay multiple sinus openings the multiple sinus openings or multiple sinus openings with abscess you can go for active microcells don't get confused multiple periodontal abscess is in the case of your diabetes mellitus okay it's our most commonly asked questions of dental students multiple periodontal abscess if you see an individual in the oral cavity oral manifestation then you can diagnose it as diabetes mellitus multiple pulp stones on radiograph okay you can you can diagnose fit as a rubber band syndrome Robin man syndrome will have multiple pulp stones on the radiographs multiple periodontal abscess are seen the case of diabetes minute I'd assigned multiple sinus opening split abscess and with the silver sulfur granules are seen in the case of your actinomycosis the most important microscopic feature that you have to make a notice sulfur granules you can see that like even if you're taking the abscess out few times you can see small small granule like things okay they are selfish and and morphologically you can see the bacteria are long branched mycelium like they look like a fungus okay so these are the diagram based things that you need to focus on particularly for this type of bacteria you can see in the first diagram when you're opening your sinus is opening out and when you are removing the pus or the discharges you can see some some sort of sulfur like granules in this in these patients okay and of course the most important diagnostic future microscopically used to identify this particular organisms is the presence of sulfur granules okay so that's an important point to be added this is the most important future okay and the next important notes to be added is the sulfur granules are bacteria colonies basically which are found in dense network with gram-positive filaments okay you can see this gram positive a filament like structures okay and this gives a sunray appearance okay this gives a sunray evidence okay so upon radiograph you can see sunray appearance in osteosarcoma okay in most of the bone cancers you can see sundry appearance okay of course and upon microscopic examination you can see sundry parents in at you know mitosis okay I hope you're clear okay and you can see the colonies in the form of molars okay they appear like molar tooth appearance the colonies appears like molar tooth appearance you can see molar tooth like appearance okay I hope you're very clear this diagram based things one is sulfur gland is the most important microscopic method by which you can identify the next one is called the sunray appearance is seen in the case of microscopic picture of these organisms and the colonies on on on on the agar plate sorry the colonies on the culture medium their beards like a monarch tooth like appearance okay and mostly the granules of your actinomycosis they appear a low colored okay they reappeared a low current okay so these are the very important points that you have to make a note particularly to these type of bacteria so apart from that I want you guys to make a note about the culture medium okay the culture medium used for this bacteria so one is you can use brain heart infusion agar okay so the brain heart infusion agar is one culture medium that is used most commonly for these bacteria and the second one is tayo glycolate liquid medium so one is brain heart infusion other and the second one is you can use diode like kool-aid a liquid medium so these two mediums are used in diagnosis so apart from the molar tooth like appearance or sunray appearance or presence of sulfur granules there are few cases where you are where you of at no mycosis can be found as small spider equalness you can see it here apart from apart from the sunray appearance you can you can diagnosis it roughly looks like a spider spider like colonies okay spider like koala nice okay so these are the important points that you have to make a note related to this particular bacteria and you can make a note again this is the most commonly asked question that is the drug of choice for this is the pencil ins okay the insulins are the drug of choice for example if a person is having a history of allergic to the pencil in and diagnosed with this particular disease then you can think of giving tetracycline okay so these are the points to bed there is one beautiful case based question given in your extra book okay so it's very easy to identify the case based question is very good and most of the points whatever we have discussed right now are already covered at night okay I'm just going to repeat it the case based question a 20 year old woman presented to the surgical outpatient department with a soft tissue swelling on the left channel okay which was painless which was cover covered with exudate on examination it discharging sinus was found she has a history of trauma to that area and the pus was sent for the culture test upon macroscopic examination a sulphur granule was fouled in the exited and Gram stain of the these granules shows the presence of some branching gram-positive filament like structure and the patient was diagnosis with cervical actinomycosis i and and the drug of choice that is given to this particular patient is the penicillin i hope we are very clear so this is how a diagram based a clinical approach question can be made in this particular area okay so that is that is that is of more important okay so just for your sake i want you guys to add few more important points this particular disease actinomycosis is most commonly seen in ruler areas okay so it's less in urban areas it is more in the low developed areas and eng males okaying male surface ten to thirty years old are the most commonly affected at the end males of ten to thirty year-old are most commonly affected and the reason for this is not known okay about 60 percentage of the cases are serviço facial okay and 20 percent is cases are abdominal okay so that these are the points to better and out of all the types of this actinomycosis what we have discussed pelvic at no mycosis are most commonly seen in the women because they're the main reason by occurrence of pelvic actinomycosis is basically do the use of intrauterine drugs i hope you are very clear about this particular organism okay i'll go back and just have a quick decent recap okay so these are gram positive sporulating non motile sorry grandpa's two non motile non sporulating non capsulated non acid-fast and the entries by a trauma or by some invasion into the body okay and make a note most commonly seen in the mails 10 to 30 years of phase except the pelvic type which is most commonly seen in the case of females ok the type 1 that is most common is hora serviço facial it's also called as lamb feature it's most commonly seen at the angle of the mandible and rest all types of this and questions may move around this type ok so all these are clear so diagram based everything is very clear Maillard shape okay you can spider spider web-like thing like some rare parents ok and the culture mediums that are used and everything drug of choice is pencil and if it doesn't work or analytic then you can think of tetracycline okay thank you so now this is dr. Shrikant signing off from team MDS conquer okay if you like this video you can please do like it share it and subscribe make a note you must subscribe this because you will get a notification if any further videos are uploaded it related to the preparation okay if you have any doubts or if you need any inquiry related to MDS conquer or anything please to drop us in the comment box so that we may help you thank you all stay safe