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Klaus P. Schaal

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date: 25 February 2021

Human actinomycoses are always synergistic polymicrobial infections in which fermentative actinomycetes—predominantly Actinomyces israelii, A. gerencseriae, or Propionibacterium propionicum—are the principal pathogens, usually needing the assistance of so-called concomitant microbes to produce disease. Nearly all of the members of the mixed actinomycotic microflora belong to the indigenous microbial community of human mucous membranes, hence actinomycoses present as sporadic endogenous infections which are not transmissible. Antibacterial drugs used for treatment should be active against both the causative actinomycetes and all concomitant bacteria. For cervicofacial actinomycoses, the rare cutaneous processes, and most thoracic forms of the disease, this requirement is best fulfilled by amoxicillin plus clavulanic acid in medium to high doses. The prognosis of cervicofacial and cutaneous actinomycoses is good provided that treatment is adequate; thoracic and abdominal forms are more serious, with grave prognosis without proper treatment.

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