Actinomycosis in Ophthalmology Medication

  • Author: Manolette R Roque, MD, MBA; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Apr 20, 2012
 

Medication Summary

Actinomyces organisms are usually susceptible to penicillins and cephalosporins. Good results have been obtained by subconjunctival penicillin coadministered with systemic iodides. Alternatively, topical sulfacetamide or penicillin can be used.

Next

Antibiotics

Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.

View full drug information

Penicillin G (Pfizerpen)

 

Exerts bactericidal action against penicillin-susceptible microorganisms during the stage of active multiplication. Acts by inhibiting biosynthesis of cell wall mucopeptide, rendering the cell wall osmotically unstable. Not active against penicillinase-producing bacteria, which include many strains of staphylococci

View full drug information

Cefazolin (Ancef, Kefzol, Zolicef)

 

First-generation cephalosporin with excellent activity against gram-positive cocci, including penicillinase-producing Staphylococcus aureus, penicillinase-producing Staphylococcus epidermidis, group A beta-hemolytic streptococci (Streptococcus pyogenes), group B streptococci (Streptococcus agalactiae), and Streptococcus pneumoniae. Ineffective against Bacteroides fragilis and only weak activity against gram-negative organisms.

Previous
Next

Antiparasitic agents

Class Summary

Parasite biochemical pathways are sufficiently different from the human host to allow selective interference by chemotherapeutic agents in relatively small doses.

View full drug information

Sulfacetamide ophthalmic (Sulamyd, Bleph-10)

 

N-acetyl-substituted derivative; at 30% solution, topical sulfacetamide has pH of 7.4 and has good tissue penetration.

Previous
Proceed to Follow-up
 
 
Contributor Information and Disclosures
Author

Manolette R Roque, MD, MBA  General Manager, Full Partner, Ophthalmic Consultants Philippines Co.; President and CEO, Chief Refractive Surgeon, EYE REPUBLIC Ophthalmology Clinic; Section Chief, Ocular Immunology and Uveitis, Department of Ophthalmology, Asian Hospital and Medical Center; Section Chief, Ocular Immunology and Uveitis, International Eye Institute, St Luke's Medical Center Global City; Senior Eye Surgeon, The LASIK Surgery Clinic; Director, AMC Eye Center, Alabang Medical Center; President, Philippine Ocular Inflammation Society

Manolette R Roque, MD, MBA is a member of the following medical societies: American Academy of Ophthalmic Executives, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Administrators, American Uveitis Society, International Ocular Inflammation Society, Philippine Medical Association, Philippine Ocular Inflammation Society, and Philippine Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Barbara L Roque, MD  Full Partner, Ophthalmic Consultants Philippines Co; Service Chief, Pediatric Ophthalmology and Strabismus, Department of Ophthalmology, Asian Hospital and Medical Center; Active Staff, International Eye Institute, St Luke's Medical Center Global City; Visiting Ophthalmologist, AMC Eye Center, Alabang Medical Center

Barbara L Roque, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Society of Cataract and Refractive Surgery, Philippine Academy of Ophthalmology, Philippine Society of Cataract and Refractive Surgery, and Philippine Society of Pediatric Ophthalmolo

Disclosure: Nothing to disclose.

C Stephen Foster, MD, FACS, FACR, FAAO  Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution

C Stephen Foster, MD, FACS, FACR, FAAO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Jorge G Camara, MD  Professor of Ophthalmology, Department of Surgery and Director of Fellowship Training Program in Ophthalmic Plastic and Reconstructive Surgery for Countries Served by the Aloha Medical Mission, University of Hawaii John A Burns School of Medicine

Jorge G Camara, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and American Society of Ophthalmic Plastic and Reconstructive Surgery

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Mark T Duffy, MD, PhD  Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic

Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience

Disclosure: Allergan - Botox Cosmetic Honoraria Speaking and teaching

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the assistance of Ryan I Huffman, MD, with the literature review and referencing for this article.

References

  1. Robboy SJ, Vickery AL Jr. Tinctorial and morphologic properties distinguishing actinomycosis and nocardiosis. N Engl J Med. Mar 12 1970;282(11):593-6. [Medline].

  2. Acevedo F, Baudrand R, Letelier LM, et al. Actinomycosis: a great pretender. Case reports of unusual presentations and a review of the literature. Int J Infect Dis. Jul 2008;12(4):358-62. [Medline].

  3. Figdor D, Davies J. Cell surface structures of Actinomyces israelii. Aust Dent J. Apr 1997;42(2):125-8. [Medline].

  4. Holmberg K, Nord CE, Wadström T. Serological studies of Actinomyces israelii by crossed immunoelectrophoresis: taxonomic and diagnostic applications. Infect Immun. Aug 1975;12(2):398-403. [Medline].

  5. Lambert FW Jr, Brown JM, Georg LK. Identification of Actinomyces israelii and Actinomyces naeslundii by fluorescent-antibody and agar-gel diffusion techniques. J Bacteriol. Nov 1967;94(5):1287-95. [Medline].

  6. Hall V. Actinomyces--gathering evidence of human colonization and infection. Anaerobe. Feb 2008;14(1):1-7. [Medline].

  7. Karimian F, Feizi S, Nazari R, et al. Delayed-onset Actinomyces keratitis after laser in situ keratomileusis. Cornea. Aug 2008;27(7):843-6. [Medline].

  8. Briscoe D, Edelstein E, Zacharopoulos I, et al. Actinomyces canaliculitis: diagnosis of a masquerading disease. Graefes Arch Clin Exp Ophthalmol. Aug 2004;242(8):682-6. [Medline].

  9. Demant E, Hurwitz JJ. Canaliculitis: review of 12 cases. Can J Ophthalmol. Apr 1980;15(2):73-5. [Medline].

  10. Eloy P, Brandt H, Nollevaux MC, et al. Solid cast-forming actinomycotic canaliculitis: case report. Rhinology. Jun 2004;42(2):103-6. [Medline].

  11. Fulmer NL, Neal JG, Bussard GM, Edlich RF. Lacrimal canaliculitis. Am J Emerg Med. Jul 1999;17(4):385-6. [Medline].

  12. Hussain I, Bonshek RE, Loudon K, et al. Canalicular infection caused by Actinomyces. Eye. 1993;7 (Pt 4):542-4. [Medline].

  13. McKellar MJ, Aburn NS. Cast-forming Actinomyces israelii canaliculitis. Aust N Z J Ophthalmol. Nov 1997;25(4):301-3. [Medline].

  14. Richards WW. Actinomycotic lacrimal canaliculitis. Am J Ophthalmol. Jan 1973;75(1):155-7. [Medline].

  15. Smith RL, Henderson PN. Actinomycotic canaliculitis. Aust J Ophthalmol. Feb 1980;8(1):75-9. [Medline].

  16. Sullivan TJ, Hakin KN, Sathananthan N, et al. Chronic canaliculitis. Aust N Z J Ophthalmol. Nov 1993;21(4):273-4. [Medline].

  17. Takemura M, Yokoi N, Nakamura Y, et al. [Canaliculitis caused by Actinomyces in a case of dry eye with punctal plug occlusion]. Nippon Ganka Gakkai Zasshi. Jul 2002;106(7):416-9. [Medline].

  18. Vécsei VP, Huber-Spitzy V, Arocker-Mettinger E, et al. Canaliculitis: difficulties in diagnosis, differential diagnosis and comparison between conservative and surgical treatment. Ophthalmologica. 1994;208(6):314-7. [Medline].

  19. Marthin JK, Lindegaard J, Prause JU, et al. Lesions of the lacrimal drainage system: a clinicopathological study of 643 biopsy specimens of the lacrimal drainage system in Denmark 1910-1999. Acta Ophthalmol Scand. Feb 2005;83(1):94-9. [Medline].

  20. Pappalardo J, Lee GA, Whitehead K. Actinomycotic granule of the caruncle: a case report. Ophthal Plast Reconstr Surg. Jul-Aug 2011;27(4):e100-2. [Medline].

  21. Shtein RM, Newton DW, Elner VM. Actinomyces infectious crystalline keratopathy. Arch Ophthalmol. Apr 2011;129(4):515-7. [Medline]. [Full Text].

  22. Perez-Santonja JJ, Campos-Mollo E, Fuentes-Campos E, et al. Actinomyces neuii subspecies anitratus chronic endophthalmitis after cataract surgery. Eur J Ophthalmol. May-Jun 2007;17(3):445-7. [Medline].

  23. Scarano FJ, Ruddat MS, Robinson A. Actinomyces viscosus postoperative endophthalmitis. Diagn Microbiol Infect Dis. Jun 1999;34(2):115-7. [Medline].

  24. Milman T, Mirani N, Gibler T, et al. Actinomyces israelii endogenous endophthalmitis. Br J Ophthalmol. Mar 2008;92(3):427-8. [Medline].

  25. Dhaliwal U, Arora VK, Singh N, et al. Clinical and cytopathologic correlation in chronic inflammations of the orbit and ocular adnexa: a review of 55 cases. Orbit. Dec 2004;23(4):219-25. [Medline].

  26. Leigh RJ, Good EF, Rudy RP. Ophthalmoplegia due to actinomycosis. J Clin Neuroophthalmol. Sep 1986;6(3):157-9. [Medline].

  27. Pagliani L, Campi L, Cavallini GM. Orbital actinomycosis associated with painful ophthalmoplegia. Actinomycosis of the orbit. Ophthalmologica. 2006;220(3):201-5. [Medline].

  28. Sullivan TJ, Aylward GW, Wright JE. Actinomycosis of the orbit. Br J Ophthalmol. Aug 1992;76(8):505-6. [Medline].

  29. Huerva V, Espinet R, Galindo C. Recurrent orbital inflammation and Whipple disease. Ocul Immunol Inflamm. Jan-Feb 2008;16(1):37-9. [Medline].

  30. Hegde V, Puthran N, Mahesha S, Anupama B. A rare and an unusually delayed presentation of orbital actinomycosis following avulsion injury of the scalp. Indian J Ophthalmol. May-Jun 2010;58(3):238-40. [Medline]. [Full Text].

  31. Stupp T, Pavlidis M, Busse H, et al. Presurgical and postsurgical ultrasound assessment of lacrimal drainage dysfunction. Am J Ophthalmol. Nov 2004;138(5):764-71. [Medline].

  32. Tost F, Bruder R, Clemens S. [20-MHz ultrasound of pre-saccular lacrimal ducts]. Ophthalmologe. Jan 2002;99(1):25-8. [Medline].

  33. Tost F, Bruder R, Clemens S. Clinical diagnosis of chronic canaliculitis by 20-MHz ultrasound. Ophthalmologica. 2000;214(6):433-6. [Medline].

  34. Tost F, Bruder R, Ostendorf M. [High-frequency ultrasonography applied to disorders of the lacrimal canaliculi (Part 2)]. J Fr Ophtalmol. Dec 2003;26(10):1035-8. [Medline].

  35. Barnard D, Davies J, Figdor D. Susceptibility of Actinomyces israelii to antibiotics, sodium hypochlorite and calcium hydroxide. Int Endod J. Sep 1996;29(5):320-6. [Medline].

  36. Martin MV. The use of oral amoxycillin for the treatment of actinomycosis. A clinical and in vitro study. Br Dent J. Apr 7 1984;156(7):252-4. [Medline].

  37. Mohr JA, Rhoades ER, Muchmore HG. Actinomycosis treated with lincomycin. JAMA. Jun 29 1970;212(13):2260-2. [Medline].

  38. Zimmerman TJ, et al, eds. Textbook of Ocular Pharmacology. Philadelphia: Lippincott-Raven; 1997.

  39. Shauly Y, Nachum Z, Gdal-On M, et al. Adjunctive hyperbaric oxygen therapy for actinomycotic lacrimal canaliculitis. Graefes Arch Clin Exp Ophthalmol. Jul 1993;231(7):429-31. [Medline].

  40. Baldursdóttir E, Sigurdsson H, Jónasson L, Gottfredsson M. Actinomycotic canaliculitis: resolution following surgery and short topical antibiotic treatment. Acta Ophthalmol. May 2010;88(3):367-70. [Medline].

  41. Georg LK, Coleman RM, Brown JM. Evaluation of an agar precipitin test for the serodiagnosis of actinomycosis. J Immunol. Jun 1968;100(6):1288-92. [Medline].

  42. Khan A, Lightman S. The eye in gastrointestinal disease. Hosp Med. Sep 2003;64(9):548-51. [Medline].

  43. Lee AG. Ocular whipple's disease. Ophthalmology. Nov 2002;109(11):1952-3; author reply 1953. [Medline].

  44. Medical Economics. Physicians' Desk Reference. NJ: Medical Economics Press; 1999.

  45. Shah JK. Actinomycosis: a ten year review. East Afr Med J. Sep 1971;48(9):496-501. [Medline].

  46. Vagarali MA, Karadesai SG, Dandur MS. Lacrimal canaliculitis due to actinomyces: a rare entity. Indian J Pathol Microbiol. Jul-Sep 2011;54(3):661-3. [Medline].

  47. Weinberg RJ, Sartoris MJ, Buerger GF Jr, et al. Fusobacterium in presumed Actinomyces canaliculitis. Am J Ophthalmol. Sep 1977;84(3):371-4. [Medline].

 
Previous
Next
 
Canaliculitis of the left lower lid. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School.
Canaliculitis of the right upper lid. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School.
A pediatric patient with canaliculitis. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School.
A patient presenting with pseudocanaliculitis secondary to a chalazion. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School.
A patient presenting with pseudocanaliculitis secondary to a chalazion. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School.
Actinomyces israelii (non–spore-forming, gram-positive bacilli). Courtesy of Medical Education Information Center, Department of Pathology and Laboratory Medicine, The University of Texas-Houston Medical School.
Actinomyces israelii. (The image is labeled.)
Actinomycosis.
Clinical slit-lamp photographs of Actinomyces infectious crystalline keratopathy (A) upon initial presentation, (B) immediately following first repeat penetrating keratoplasty, and (C and D) low and high magnification of recurrent corneal opacities 6 months later. White arrows highlight temporal opacity within host cornea.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.