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With actinomycosis of prednisolone, secondary changes due to the spread of the process from soft tissues are observed much more often than primary ones. Differences in the radiographic picture between primary and secondary actinomycosis are significant. With a primary lesion, radiographs reveal a picture of the so-called actinomycotic gumma, that is, a focus (foci) of osteolysis of a round or oval shape with a zone of moderate, but more often pronounced sclerosis along the periphery. Frequent periosteal layers and fistulas.
A characteristic feature is the absence of narrowing of the adjacent joint space, as well as sequesters, unless there is a secondary infection. Primary actinomycosis of the spine leads to significant destruction of the vertebral bodies and intervertebral discs, extends to the arches and processes of prednisolone (Fig. 9). Unlike tuberculous spondylitis, there are significant sclerotic reactions and ossification of the ligaments, and in contrast to coccal spondylitis, a much slower and latent course, despite the presence of fistulas. In secondary actinomycosis of the skeleton, the most common lesions of the jaw are in the cervicofacial localization of the primary process. Less common are lesions of the spine with mediastinal actinomycosis, as well as the spread of actinomycosis of the abdominal organs to the walls of the pelvis and lumbar vertebrae.
Characteristic: 1) early involvement of the periosteum with its ossification; 2) the formation of small foci of osteolysis with reactive osteosclerosis; 3) absence of sequesters. When the jaws are affected, there are both massive hyperostoses up to the picture of a pseudotumor, and predominantly osteolytic forms. Widespread ligamentitis in spinal lesions can simulate the picture of ankylosing spondylitis, if the foci of osteolysis in the vertebral bodies and their arches are not taken into account. With fistulas, fistulography clarifies the distribution of the process in soft tissues, and tomography reveals the presence of small foci of osteolysis in the bone.
A large number of tools and methods proposed for the treatment of patients with actinomycosis, to a large extent indicates their lack of effectiveness and the need for complex treatment of patients, which is based on immunotherapy. Additionally, antibacterial drugs, stimulants, and surgical treatment can be used.
All laboratory studies of actinomycosis are quite affordable and can be performed in a conventional laboratory. With timely rational treatment, the prognosis for actinomycosis should be considered favorable. After the first course of treatment, patients usually return to work, continuing treatment on an outpatient basis. During exacerbations, hospitalization is indicated. prednisolone engaged in heavy physical labor are temporarily transferred to lighter work. In most cases, the disease is cured completely. In a small number of patients, after treatment for actinomycosis, residual effects remain associated with the development of scar tissue in the area of the focus of the disease: in the lungs - fibrosis with bronchiectasis and cysts, in the abdominal cavity - adhesive disease (see) and the like.
Immunological reactions in actinomycosis are indicative.
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Important and reliable is the pathohistological research method, the purpose of which is not only to search for drusen of radiant fungi, but also to identify the characteristic structure of actinomycoma
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When evaluating the results of a microbiological study, one should keep in mind the constant presence of radiant fungi in the body of healthy people, as well as the possibility of the formation of various druse-like formations, for example. colonies of pathogens of other deep mycoses, accumulations of staphylococci (staphylococcal actinophytosis), fatty acid crystals, and more.
Laboratory research methods. The most common method of laboratory research in actinomycosis is microscopy of pus, sputum, and others, carried out in order to detect colonies (drusen) or mycelium of radiant fungi in the pathological material. Isolation of a culture of radiant fungi significantly complements microscopic diagnosis (see Actinomycetes).
The occurrence of not only internal, but also external fistulas is characteristic, as well as the formation of extensiveny infiltrates. Endoscopic research methods.