Actinomyces (Actinomycotic Mycetoma) with Splendore-Hoeppli phenomenon: 5-Minute Pathology Pearls

[@JMGardnerMD]

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

[@archanabhaskaran6384]

This is likely actinomycosis (caused by Actinomyces) rather than Actinomycetoma (caused by Nocardia, Actinomadura or Streptomyces). Both cause sulfur granules and splendore-hoeppli phenomenon. Former is an endogenous infection and occurs in cervicafacial, thoracoabdominal areas, latter is an exogenously acquired infection and occurs in limbs.

[@maxhr1749]

Actinomycetecomitans I deal with on a regular basis when treating periodontitis!

[@ranakhsheibun6499]

BIG THANK YOU DR. GARDNER :) YOU are a life saver with your videos !! Keep it up :)

[@reshmakurian1107]

What is the difference between Actinomyces and Actinomycetes sir

[@Lokinenivenugopalrao]

EXCELLENT ...VERY INFORMATIVE ALL YOUR VIDEOS..MAKE VIDEO ON ALL IMPORTANT AND COMMON TOPICS..THANK U DR JERAD GARDNER AND TEAM.

[@kashifofficial5820]

Where is esinophilic material sir

[@kashifofficial5820]

Mandell text book writes the esinophilic protenacious material coating organisms can any one elaborate

[@lilakhattri7762]

As you said if you find this organism in foot then it would most probably be a fungi. But if it were to be a fungi on foot then would not the fungal hyphae be appreciable enough to be distinguished from filamentous bacteria??

[@JMGardnerMD]

Yes usually

[@calvintseng2168]

Thanks for the video Dr. Gardner! Just wondering, would one do a modified acid-fast stain to exclude nocardia in these cases? Thanks if you have time!

[@JMGardnerMD]

Theoretically yes. In practice, I haven’t done that as I’ve only rarely seen cases of actinomyces or nocardia. The rare Nocardia I’ve seen wasn’t arranged into such dramatic sulfur granules like this (video of that case coming in next month or so). Ultimately, cultures or molecular are the key to knowing species for sure.

[@calvintseng2168]

Thanks so much!

[@ncorry8491]

Thanks

[@keratinpearls5058]

Splendore hoeppli