Patho

• Actinomycosis is caused by actinomyses israeli, it's a commensal in mouth, caries tooth and intestine. Grossly, it appears as intercommuncating absecc with multiple sinuses discharging sulphur granules. Microscopically, it consists of 3 zones

  1. Centeral: pus containing rounded or oval
  2. Mid: plasma cells, polym, pus cells, lymphocytes, macrophages and giant cells.
  3. Outer: fibrosis
• Types of actinomycosis

  1. Carvicofacial
  2. Intestinal
  3. Pulmonary
  4. Skin
• Rhinoscleroma is a granulumatous inflammation of the nose, may also affect larynx and pharynx. Caused by jlebsiella rhinoscleromatis. Thus bacteria is endemic in Egypt. Macrophage after engulfing them and having foamy cytoplasm are called Mickulicz cells. Grossly, the lesion is small nodular gard mass filling nasal cavity. ComplicatComplications are:

  1. Nasal obstruction and deformity
  2. Ulceration and 2ry infection
• Tuberculosis is an infectious disease caused by mycobacterium tuberculosis. It can be pulmonary (primary) or extrapulmonary (secondary). Primary TB occurs when there is initial exposure to the organism. Secondary TB occurs when reactivation happens due to weakened immune system.