In the discharge, small grains of usually yellowish color (druze) are noticeable. The nodes are almost painless. The process slowly progresses, the entire sole is pierced with knots, the toes turn up. Then nodes and Zovirax passages appear on the back of the foot. The entire foot becomes a deformed and pigmented mass riddled with fistulas and cavities. The process can move to muscles, tendons and bones. Sometimes there is atrophy of the leg muscles. Usually the process captures only one foot. The disease continues for a very long time (10-20 years).
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Complications. Layering secondary bacterial infection. In advanced cases with the formation of fistulas and characteristic changes in the skin, the diagnosis is not difficult. It is more difficult to diagnose the initial forms of actinomycosis.
An intradermal test with actinolysate is of some importance for diagnosis. However, only positive and sharply positive tests should be taken into account, since weakly positive intradermal tests often occur in patients with dental Acyclovir (for example, with alveolar pyorrhea). Negative test results do not always allow us to exclude actinomycosis, since in patients with severe forms they can be negative due to a sharp suppression of cellular immunity; they are always negative in HIV-infected people.
Isolation of a culture of actinomycetes from sputum, mucous membrane of the pharynx, nose has no diagnostic value, since actinomycetes are often found in healthy individuals. Diagnostic value has RSK with actinolysate, which is positive in 80% of patients. Of greatest diagnostic value is the isolation (detection) of actinomycetes in pus from fistulas, in biopsy specimens of affected tissues, in druses, in the latter, only Acyclovir filaments are sometimes microscopically detected. In these cases, you can try to isolate the culture of actinomycetes by inoculating the material on Sabur's medium.