Cutaneous and Subcutaneous Forms

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The page below is a sample from the LabCE course Medically Important Aerobic Actinomycetes. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Cutaneous and Subcutaneous Forms

The aerobic actinomycetes may present as wounds of two different forms, cutaneous and subcutaneous.
Cutaneous:
  • Superficial abscess
  • Localized cellulitis
Subcutaneous:
  • Mycetoma involving swelling of subcutaneous tissues and formation of sinus tracts, usually in the extremities, forming pus
  • Chronic/systemic and progressive infection, spreading to deep tissues and bone
Figure 4. CDC/Georg. (1967). Image #21783. Seen from a lateral perspective, this patient had contracted a nocardiosis infection of his left foot, due to Gram-positive, Nocardia asteroides [no longer known as asteroides, but as specific species] bacteria, which had manifested into a cellulitic inflammation, known as an actinomycotic mycetoma. Note the presence of chronic subcutaneous nodules over the dorsum of the foot. PHIL public domain. https://phil.cdc.gov/Details.aspx?pid=21783
Figure 5. CDC/Victoria/Georg. (1971). Image #14816. Depicted here, is a dorsal view of a patient’s left foot, which exhibited pathologic changes indicative of a mycetoma, due to the cutaneous invasion of the Gram-positive, Streptomyces somaliensis bacterial organisms. PHIL public domain. https://phil.cdc.gov/Details.aspx?pid=14816

Figure 4. Cellulitic inflammation of the foot becoming an actinomycotic mycetoma due to Nocardia
Figure 5. Mycetoma of the foot due to Streptomyces infection