Actinomycosis of mammary glands - chronic specific damage of mammary glands, the form of visceral mycosis proceeding with formation of granulomas and abscesses. The clinic of actinomycosis of mammary glands is characterized by formation of separate small small knots, then abscesses which are opened with education is long not healing fistulas. The diagnosis of actinomycosis of mammary glands is established, proceeding from detection of actinomycetes in separated fistulas. Treatment includes a resection of the site of the affected mammary gland, purpose of aktinolizat, penicillin, vitamins, immunomodulators.
Actinomycosis of mammary glands
In a mammology actinomycosis meets in 0,05-0,1% of all cases of inflammatory diseases of mammary glands. Reference of a disease to group of mycoses is quite conditional; it is based on morphological similarity of the activator to fungi and a current, characteristic of mikotichesky defeats. Causative agents of actinomycosis of mammary glands – radiant fungi (actinomycetes) represent bacterial cages. Cases of the isolated actinomycosis of mammary glands are single; as a rule, the combined or system defeat is usually observed. Actinomycosis can affect one or both mammary glands, be followed by formation of single or multiple abscesses.
Reasons of development of actinomycosis of mammary glands
For actinomycosis of mammary glands the endogenous way of penetration of the activator is primary. In an organism actinomycetes can be present at an oral cavity - in the teeth affected with caries, crypts of almonds. Activators get to tissues of a mammary gland through cracks of nipples and the damaged integuments.
At secondary actinomycosis of mammary glands primary center settles down in other bodies, for example, in lungs. In this case edges both soft tissues of a thorax, and then and mammary glands are involved in process at first. Hematogenic distribution of actinomycetes is possible at generalized infectious process. The aktinomikotichesky centers of defeat consistently pass the following stages in the development: infiltrative, abstsedirovaniye and svishchevy.
In the place of introduction of actinomycetes hypostasis and hyperaemia of fabrics originally develops, there is a formation of young fibroblast, plasmatic and ksantomny cages, new vessels. The aktinomikotichesky small knot - a granuloma (aktinomikoma) around which additional small knots are formed further is so formed. At merge of the separate centers infiltrate with zones of purulent fusion is formed. Gradually purulent process extends on cellulose towards skin and is opened outside with formation of fistulas.
At actinomycosis of mammary glands the destructive form with prevalence of destruction of fabrics and formation of big abscesses or the destructive and proliferative form which is characterized by growth of connecting fabric and destructive changes can develop. The Aktinomikotichesky granuloma has a dense consistence, on a section its sotovidny structure, flavovirent coloring, whitish impregnations – Druzes (a congestion of actinomycetes) is defined.
Symptoms of actinomycosis of mammary glands
Usually patients note emergence in a nipple of small hyperemic small knots which then turn into dense and painful infiltrates, and in the subsequent – in abscesses. Skin over abscesses gets violet coloring.
On the place of the opened abscesses are formed it is long not beginning to live svishchevy courses from which pus is periodically emitted. Actinomycosis of mammary glands is not contagious disease; without treatment can proceed for years and tend to progressing.
Diagnosis of actinomycosis of mammary glands
At survey of mammary glands by the mammologist existence of the infiltrative centers of cyanotic-red coloring, the numerous svishchevy courses from which when squeezing purulent separated follows is noted. In the presence of actinomycosis of other localizations the diagnosis does not raise doubts.
Separated from fistulas of a mammary gland (dab microscopy, bacteriological crops on nutrient mediums) actinomycetes and congestions the Druze of a fungus in the form of radiant educations — reinforced threads of a mycelium with characteristic kolbovidny expansions on the end allows to reveal a research. Also in laboratory diagnostics serological methods (IFA) are applied.
Specific methods of a research which the mammology usually applies to diagnosis of diseases of a mammary gland (ultrasonography of mammary glands, mammography, MRT of a mammary gland, KT, etc.), at actinomycosis are not informative. Differential diagnostics at actinomycosis is carried out with tuberculosis, syphilis of mammary glands, chronic mastitis.
Treatment of actinomycosis of mammary glands
At actinomycosis of mammary glands complex conservative and surgical treatment is carried out. It is long, within several months antibiotics of a penicillinic row, an aktinolizata, immunoproofreaders, vitamins, physical therapy are appointed (Ural federal district, UVCh).
At the course of actinomycosis of mammary glands, progressing or resistant to therapy, opening and depletion of abscesses, excision of fistulas after a preliminary prokrashivaniye of the svishchevy courses is made. At extensive defeat the sectoral resection of a mammary gland is shown. In case of the total purulent process which is followed by gangrene of a mammary gland the mastectomy from the subsequent reconstructive mammoplastiky is carried out.
Forecast and prevention of actinomycosis of mammary glands
Treatment of actinomycosis of mammary glands, as a rule, difficult and long. Clinical recovery can be replaced by a recurrence again, dragging on for many years. The forecast at actinomycosis of mammary glands is favorable for life, however features of a current negatively affect working ability of patients and their social adaptation.
Prevention of actinomycosis of mammary glands assumes timely treatment of cracks of nipples and the centers of actinomycosis of other visceral localization, the prevention of injuries of mammary glands, treatment of caries, diseases of a rotoglotka and a GIT.