Actinomyces israelii

CGD is characterized by recurrent life-threatening infections and excessive granuloma formation, involving the lungs, skin, soft tissues, and reticuloendothelial system. Recurrent deep-seated infections with catalase-positive organisms such as Staphylococcus aureus or Aspergillus fumigatus are typical.

However, catalase-dependent virulence is not the complete story, because most pathogens in general are catalase-positive, but only a small subset is encountered in CGD patients: Staphylococcus aureus, Serratia marcescens, Burkholderia cepacia, Nocardiaspp., and Aspergillus species. The frequency of infection with catalase negative organisms in CGD is extremely low. CGD, 5% of abscesses yielded streptococci but the number that were in pure culture is unknown.

Nocardia infections are almost exclusively seen in immunocompromised patients and are important causes of infection in patients with CGD. Nocardia species have been implicated as the causes of pulmonary, cutaneous, ocular, and disseminated diseases in both immunocompetent and immunocompromised human hosts. Over the past several years the spectrum of disease caused by Nocardia species has changed due to the increase in the number of immunocompromised patients. Infection with Nocardiaposes a diagnostic challenge in patients with CGD because the signs and symptoms are often nonspecific, delay in diagnosis is common, and invasive procedures are frequently required to obtain appropriate tissue specimens.

Actinomycosis is a chronic granulomatous condition that commonly manifests as cervicofacial, pulmonary, or abdominal disease caused by slowly progressive infection with oral and gastrointestinal communal Actinomyces israelii.

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