Acute myeloid leukaemia – what are the signs and symptoms of acute myeloid leukaemia

Leukaemia is cancer of the white blood cells. Acute leukaemia means it progresses rapidly and aggressively, and usually requires immediate treatment.

Signs of acute leukaemia
Signs of acute leukaemia

Acute leukaemia is classified according to the type of white blood cells affected. The two main types of white blood cells are:

  • lymphocytes – mostly used to fight viral infections
  • myeloid cells – which perform a number of different functions, such as fighting bacterial infections, defending the body against parasites and preventing the spread of tissue damage

This topic focuses on acute myeloid leukaemia (AML), which is an aggressive cancer of the myeloid cells. The following types of leukaemia are covered separately:

Signs and symptoms of AML

The symptoms of AML usually develop over a few weeks and become increasingly more severe. Symptoms can include:




  • pale skin
  • tiredness
  • breathlessness
  • frequent infections
  • unusual and frequent bleeding, such as bleeding gums or nosebleeds

In more advanced cases, AML can make you extremely vulnerable to life-threatening infections or serious internal bleeding.

Read more about the complications of AML.

Seeking medical advice

You should see your GP if you or your child have possible symptoms of AML. Although it’s highly unlikely that leukaemia is the cause, these symptoms should be investigated.

If your GP thinks you may have leukaemia, they’ll arrange blood tests to check your blood cell production. If the tests suggest there’s a problem, you’ll be urgently referred to a haematologist (a specialist in treating blood conditions) for further tests and any necessary treatment.

Read more about diagnosing AML.

What causes AML?

AML occurs when specialised cells called stem cells, which are found in the bone marrow (a spongy material inside the bones), produce too many immature white blood cells. These immature cells are known as blast cells.

Blast cells don’t have the infection-fighting properties of healthy white blood cells, and producing too many can lead to a decrease in the number of red blood cells (which carry oxygen in the blood) and platelets (cells that help the blood to clot).

It’s not clear exactly why this happens and, in most cases, there’s no identifiable cause. However, a number of factors that can increase your risk of developing AML have been identified. These include:

  • previous chemotherapy or radiotherapy
  • exposure to very high levels of radiation (including previous  radiotherapy treatment)
  • exposure to benzene – a chemical used in manufacturing that’s also found in cigarette smoke
  • having an underlying blood disorder or genetic disorder, such as Down’s syndrome

Read more about the causes of AML.

Who’s affected

AML is a rare type of cancer, with around 2,600 people diagnosed with it each year in the UK.

The risk of developing AML increases with age. It’s most common in people over 65.

How AML is treated

AML is an aggressive type of cancer that can develop rapidly, so treatment usually needs to begin soon after a diagnosis is confirmed.

Chemotherapy is the main treatment for AML. It’s used to kill as many leukaemia cells in your body as possible and reduce the risk of the condition coming back (relapsing).

In some cases, intensive chemotherapy and radiotherapy may be needed, in combination with a bone marrow or stem cell transplant, to achieve a cure.

Read more about treating AML.

Outlook

The outlook for AML largely depends on the specific type of AML you have, as well as your age and general health.

There are many subtypes of AML, which are classified according to various features – such as the specific genetic changes in the leukaemia cells. Some types of AML are more challenging to treat than others.

Even if treatment is initially successful, there’s still a significant risk that the condition will return at some point during the next few years. If this happens, treatment may need to be repeated.

A number of medical trials have suggested that almost half of those aged under 60 diagnosed with AML will live for at least five years, and in some types of AML, such as acute promyeloid leukaemia (APML), around 85% will live for at least five years.

In general, the outlook for children with AML tends to be better than that of adults diagnosed with the condition.

Acute lymphoblastic leukaemia – what are the signs and symptoms of acute lymphoblastic leukaemia?

Leukaemia is cancer of the white blood cells. Acute leukaemia means the condition progresses rapidly and aggressively and requires immediate treatment.

Signs of acute lymphoblastic leukaemia
Signs of acute lymphoblastic leukaemia

Acute leukaemia is classified according to the type of white blood cells affected by cancer. There are two main types:

  • lymphocytes, which are mostly used to fight viral infections
  • neutrophils, which perform several functions, such as fighting bacterial infections, defending the body against parasites and preventing the spread of tissue damage



These pages focus on acute lymphoblastic leukaemia, which is cancer of the lymphocytes. The following other types of leukaemia are covered elsewhere:

Warning signs of acute leukaemia

Symptoms of acute lymphoblastic leukaemia usually begin slowly before rapidly getting severe as the number of immature white blood cells in your blood increases (see below for an explanation of this). Symptoms include:

  • pale skin
  • tiredness
  • breathlessness
  • having repeated infections over a short space of time
  • unusual and frequent bleeding

Read more about the symptoms of acute lymphoblastic leukaemia.

What happens in acute leukaemia

All of the blood cells in the body are produced by bone marrow – a spongy material found inside bones.

Bone marrow produces specialised cells called stem cells which have the ability to develop into three important types of blood cells:

  • red blood cells, which carry oxygen around the body
  • white blood cells, which help fight infection
  • platelets, which help stop bleeding

Usually the bone marrow produces stem cells which are allowed to fully develop before being released into the blood. But in acute leukaemia, bone marrow starts releasing large numbers of immature white blood cells known as blast cells.

As the number of blast cells increases there is a drop in the number of red blood cells and platelet cells. This drop causes the symptoms of anaemia, such as tiredness, and increases the risk of excessive bleeding.




Also, blast cells are less effective than mature white blood cells at fighting bacteria and viruses, making you more vulnerable to infection.

How common is acute lymphoblastic leukaemia?

Around 8,600 people are diagnosed with leukaemia each year in the UK. In 2011, 654 people were diagnosed with acute lymphoblastic leukaemia.

Despite being uncommon overall, acute lymphoblastic leukaemia is the most common type of cancer to affect children. Approximately one in every 2,000 children will develop it. About 85% of cases occur in children aged under 15, mostly between the ages of two and five years old.

The cause or causes of acute leukaemia are uncertain, but known risk factors include:

  • exposure to high levels of radiation
  • exposure to benzene, a chemical used in manufacturing that is also found in cigarettes

Read more information about the causes of acute lymphoblastic leukaemia.

Outlook

The outlook for children with acute lymphoblastic leukaemia is usually good. Almost all children will achieve a remission (a period of time where they are free from symptoms) from their symptoms, and 85% will be completely cured.

The outlook for adults with acute lymphoblastic leukaemia is less promising as only 40% of people with the condition will be completely cured.

Treatments for acute lymphoblastic leukaemia usually involve a combination of chemotherapy and radiotherapy. In some cases, a bone marrow transplant may also be needed to achieve a cure.

Read more about the treatment of acute lymphoblastic leukaemia.

If a cure is not possible, there is a risk that the lack of healthy blood cells can make the person extremely vulnerable to life-threatening infections (due to the lack of white blood cells) or uncontrolled and serious bleeding (due to the lack of platelets).

[Original article on NHS Choices website]

Acute Kidney Injury – what are the signs and symptoms of AKI?

World Kidney Day
World Kidney Day

Acute kidney injury (AKI) is sudden damage to the kidneys that causes them to stop working properly.

It can range from minor loss of kidney function to complete kidney failure.

AKI is common and normally happens as a complication of another serious illness. It is not the result of a physical blow to the kidneys, as the name may suggest.


This type of kidney damage is usually seen in older people who are unwell enough to be admitted to hospital. For more information, read about who’s at risk of AKI.

If it’s not picked up in time, the kidneys become overwhelmed and shut down, leading to irreversible injury, which can be fatal. Abnormal levels of salts and chemicals build up in the body, stopping other organs working properly.

It’s essential that AKI is detected early and treated promptly.

What are the symptoms?

In the early stages of AKI, there may not be any symptoms. The only possible warning sign may be that the person isn’t producing much urine, although this isn’t always the case.

However, someone with AKI can deteriorate quickly and suddenly experience any of the following:

  • nausea and vomiting
  • dehydration
  • confusion
  • high blood pressure
  • abdominal pain
  • slight backache
  • a build-up of fluid in the body (oedema)

Even if it doesn’t progress to kidney failure, AKI needs to be taken seriously, as it has an effect on the whole body and can make some existing illnesses more serious.

AKI differs to chronic kidney disease, where the kidneys gradually lose function over a long period of time.

Who’s at risk of AKI?

You’re more likely to get AKI if:

  • you are aged 65 or over
  • you already have a kidney problem such as chronic kidney disease
  • you have a long-term disease such as heart failureliver disease or diabetes
  • you are dehydrated or dependent on a carer for fluids
  • you have a blockage in your urinary tract (or are at risk of this)
  • you have a severe infection or sepsis (where the body’s immune system goes into overdrive, setting off a series of reactions including widespread inflammation and blood clotting)
  • you have taken certain medicines within the past week,
  • aminoglycosides – a type of antibiotic; again, these are only an issue if the patient is dehydrated or ill

AKI is estimated to affect 13-18% of people admitted to hospital. It affects both adults and children.

What’s the cause?

Most cases of AKI are due to reduced blood flow to the kidneys, usually in a patient who is already unwell with another health condition.

This reduced blood flow could be caused by:

  • low blood volume after bleeding, excessive vomiting or diarrhoea, or as seen with severe dehydration
  • the heart pumping out less blood than normal as a result of heart failure, liver failure or sepsis, for example
  • problems with the blood vessels – such as inflammation and blockage in the main blood vessels supplying the kidneys (a rare condition called vasculitis)
  • certain medicines (see above), which can affect the blood supply to the kidney or cause a reaction in the kidney itself
  • contrast medium – the liquid dye used for some types of scans and X-rays

AKI can also be caused by a problem with the kidney itself, such as glomerulonephritis (damage to the tiny filters inside the kidneys).

It may also be due to a blockage affecting the drainage of the kidneys, such as an enlarged prostate, a bladder tumour or kidney stones.

When should it be suspected?

Doctors should suspect AKI if their patient:

  • suddenly falls ill and is already at risk of AKI
  • has been unwell for a while and has:
    – chronic kidney disease, or
    – a urinary system disease, or
    – new or worsening urinary symptoms or
    – symptoms or signs of a disease affecting the kidneys and other organs
  • has symptoms suggesting they have developed complications of AKI

How is acute kidney injury diagnosed?

AKI can be diagnosed after measuring urine output and doing blood tests.

Blood levels of creatinine – a chemical waste product produced by the muscles – will also be measured. Healthy kidneys filter creatinine and other waste products from the blood, in the form of urine. It is an easy and quick marker of kidney function, with higher levels indicating poorer kidney function.

In adults, a diagnosis of AKI can be made if:

  • blood creatinine level has risen from the baseline value for that person (by 26 micromoles per litre or more within 48 hours)
  • blood creatinine level has risen over time (by 50% or more within the past 7 days)
  • they are passing much less urine (less than 0.5ml per kg per hour for more than 6 hours)

In children and teenagers, doctors should use the plasma creatinine level to calculate “estimated glomerular filtration rate” (eGFR). A diagnosis of AKI is made if they have a 25% or greater fall in eGFR within the past 7 days. Read more aboutAKI in children.

Investigating the underlying cause

Urine will be tested for protein, blood cells, sugar and waste products, which may give clues as to the underlying cause.

Doctors will need to know if their patient has any other symptoms (such as signs of sepsis or signs of heart failure) or any other medical condition.

They will also want to know about any drugs their patient may have taken in the past week, as some medicines can cause AKI.

An ultrasound scan should reveal if the cause is a blockage in the urinary system, such as an enlarged prostate or bladder tumour.

How is it treated?

Treatment of AKI will depend on the underlying cause and extent of illness. In most cases, treating the underlying problem will cure the AKI.

GPs may be able to manage mild cases, if the patient isn’t in hospital. They may:

  • advise stopping any medication that may be the cause
  • treat any underlying infections
  • advise on fluid intake to prevent dehydration (which could cause or worsen AKI)
  • take blood tests to monitor levels of creatinine and salt, to check their patient is recovering
  • refer their patient to a urologist (urinary specialist) or nephrologist (kidney specialist) if the cause isn’t clear or if a more serious cause is suspected

Admission to hospital is necessary if:

  • the underlying cause needs urgently treating – such as a urinary blockage, or if the person is seriously unwell; most people need hospital care to treat the underlying cause of AKI, not the AKI itself
  • there’s a risk of urinary blockage – because of prostate disease, for example
  • the patient’s condition has deteriorated and regular blood and urine tests are needed to monitor how well their kidneys are working
  • the patient has a complication of AKI

The majority of people who recover from AKI end up with the same level of kidney function as they had before they became ill, or go on to have normal kidney function.

However, some will go on to develop chronic kidney disease or long-term kidney failure as a result. In severe cases, dialysis – where a machine filters the blood to rid the body of harmful waste, extra salt and water – may be necessary.

How can acute kidney injury be prevented?

Anyone who is at risk of AKI should be monitored if they become unwell or start new medication.

They should have regular blood tests to measure their levels of creatinine. It’s also useful for the patient or carers to check how much urine they are passing.

Any warning signs of AKI, such as vomiting and producing little urine, should prompt immediate investigation for AKI and treatment. Fluids may need to be given via a drip if the patient is dehydrated or at risk of dehydration.

Any medicine that seems to be damaging the kidneys needs to be stopped.

In 2013, the National Institute for Health and Care Excellence (NICE) produced detailed guidelines on preventing, detecting and managing AKI. Read the NICE guidelines here.

What are the possible complications?

The most serious complications of acute kidney injury are:

  • high levels of potassium in the blood – in severe cases this can lead to muscle weakness, paralysis and heart rhythm problems
  • fluid in the lungs (pulmonary oedema)
  • acidic blood (metabolic acidosis), which can cause nausea, vomiting, drowsiness and breathlessness

[Original article on NHS Choices website]

Acute cholecystitis – find out more about the signs and symptoms of swelling of the gallbladder.

Acute cholecystitis
Acute cholecystitis

Acute cholecystitis is swelling (inflammation) of the gallbladder. It is a potentially serious condition that usually needs to be treated in hospital.

The main symptom of acute cholecystitis is a sudden sharp pain in the upper right side of your tummy (abdomen) that spreads towards your right shoulder.

The affected part of the abdomen is usually extremely tender, and breathing deeply can make the pain worse.

Unlike some others types of abdominal pain, the pain associated with acute cholecystitis is usually persistent, and doesn’t go away within a few hours.


Some people may additional symptoms, such as:

  • a high temperature (fever)
  • nausea and vomiting
  • sweating
  • loss of appetite
  • yellowing of the skin and the whites of the eyes (jaundice)
  • a bulge in the abdomen

When to seek medical advice

You should see your GP as soon as possible if you develop sudden and severe abdominal pain, particularly if the pain lasts longer than a few hours or is accompanied by other symptoms, such as jaundice and a fever.

If it’s not possible to contact your GP immediately, phone your local out-of-hours service or call NHS 111 for advice.

It’s important for acute cholecystitis to be diagnosed as soon as possible, because there is a risk that serious complications could develop if the condition is not treated promptly (see below).

What causes acute cholecystitis?

The causes of acute cholecystitis can be grouped into two main categories: calculous cholecystitis and acalculous cholecystitis.

Calculous cholecystitis

Calculous cholecystitis is the most common, and usually less serious, type of acute cholecystitis. It accounts for around 95% of all cases.

Calculous cholecystitis develops when the main opening to the gallbladder, called the cystic duct, gets blocked by a gallstone or by a substance known as biliary sludge.

Biliary sludge is a mixture of bile (a liquid produced by the liver that helps digest fats) and small crystals of cholesterol and salt.

The blockage in the cystic duct results in a build-up of bile in the gallbladder, increasing the pressure inside it and causing it to become inflamed. In around one in every five cases, the inflamed gallbladder also becomes infected by bacteria.

Acalculous cholecystitis

Acalculous cholecystitis is a less common, but usually more serious, type of acute cholecystitis. It usually develops as a complication of a serious illness, infection or injury that damages the gallbladder.

Acalculous cholecystitis is often associated with problems such as accidental damage to the gallbladder during major surgery, serious injuries or burns, blood poisoning (sepsis), severe malnutrition or AIDS.

Who is affected

Acute cholecystitis is a relatively common complication of gallstones.

It is estimated that around 10-15% of adults in the UK have gallstones. These don’t usually cause any symptoms, but in a small proportion of people they can cause infrequent episodes of pain (known as biliary colic) or acute cholecystitis.

In England, around 28,000 cases of cholecystitis were reported during 2012-13.

Diagnosing cholecystitis

To diagnose acute cholecystitis, your GP will examine your abdomen.

They will probably carry out a simple test called Murphy’s sign. You will be asked to breathe in deeply with your GP’s hand pressed on your tummy, just below your rib cage.

Your gallbladder will move downwards as your breathe in and, if you have cholecystitis, you will experience sudden pain as your gallbladder reaches your doctor’s hand.

If your symptoms suggest you have acute cholecystitis, your GP will refer you to hospital immediately for further tests and treatment.

Tests you may have in hospital include:

  • blood tests to check for signs of inflammation in your body
  • an ultrasound scan of your abdomen to check for gallstones or other signs of a problem with your gallbladder

Other scans – such as an X-ray, a computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan – may also be carried out to examine your gallbladder in more detail if there is any uncertainty about your diagnosis.

Treating acute cholecystitis

If you are diagnosed with acute cholecystitis, you will probably need to be admitted to hospital for treatment.

Initial treatment

Initial treatment will usually involve:

  • fasting (not eating or drinking) to take the strain off your gallbladder
  • receiving fluids through a drip directly into a vein (intravenously) to prevent dehydration
  • taking medication to relieve your pain

If you have a suspected infection, you will also be given antibiotics. These often need to be continued for up to a week, during which time you may need to stay in hospital or you may be able to go home.

With this initial treatment, any gallstones that may have caused the condition usually fall back into the gallbladder and the inflammation often settles down.

Surgery

In order to prevent acute cholecystitis recurring, and reduce your risk of developing potentially serious complications, the removal of your gallbladder will often be recommended at some point after the initial treatment. This type of surgery is known as a cholecystectomy.

Although uncommon, an alternative procedure called a percutaneous cholecystostomy may be carried out if you are too unwell to have surgery. This is where a needle is inserted through your abdomen to drain away the fluid that has built up in the gallbladder.

If you are fit enough to have surgery, your doctors will need to decide when the best time to remove your gallbladder may be. In some cases, you may need to have surgery immediately or in the next day or two, while in other cases you may be advised to wait for the inflammation to fully resolve over the next few weeks.

Surgery can be carried out in two main ways:

  • laparoscopic cholecystectomy – a type of keyhole surgery where the gallbladder is removed using special surgical instruments inserted through a number of small cuts (incisions) in your abdomen
  • open cholecystectomy – where the gallbladder is removed through a single, larger incision in your abdomen

Although some people who have had their gallbladder removed have reported symptoms of bloating and diarrhoea after eating certain foods, you can lead a perfectly normal life without a gallbladder.

The organ can be useful but it’s not essential, as your liver will still produce bile to digest food.

Read more about recovering from gallbladder removal.

Possible complications

Without appropriate treatment, acute cholecystitis can sometimes lead to potentially life-threatening complications.

The main complications of acute cholecystitis are:

  • the death of the tissue of the gallbladder, called gangrenous cholecystitis, which can cause a serious infection that could spread throughout the body
  • the gallbladder splitting open, known as a perforated gallbladder, which can spread the infection within your abdomen (peritonitis) or lead to a build-up of pus (abscess)

In about one in every five cases of acute cholecystitis, emergency surgery to remove the gallbladder is needed to treat these complications.

Preventing acute cholecystitis

It’s not always possible to prevent acute cholecystitis, but you can reduce your risk of developing the condition by cutting your risk of gallstones.

One of the main steps you can take to help lower your chances of developing gallstones is adopting a healthy, balanced diet and reducing the number of high-cholesterol foods you eat, as cholesterol is thought to contribute to the formation of gallstones.

Being overweight, particularly being obese, also increases your risk of developing gallstones. You should therefore control your weight by eating a healthy diet and exercising regularly.

However, low-calorie, rapid weight loss diets should be avoided, because there is evidence they can disrupt your bile chemistry and actually increase your risk of developing gallstones. A more gradual weight loss plan is best.

Read more about preventing gallstones.

[Original article on NHS Choices website]

Actinomycosis – what are the signs and symptoms of actinomycosis?

Actinomycosis
Actinomycosis

Introduction

Actinomycosis is a rare type of bacterial infection caused by a group of bacteria called actinomycetaceae.

Most bacterial infections are confined to one part of the body because the bacteria are unable to penetrate the body’s tissue.

However, actinomycosis is unusual in that the infection is able to move slowly but steadily through body tissue.


Symptoms of actinomycosis vary depending on the type of infection, but can include:

  • swelling and inflammation of affected tissue
  • tissue damage that results in scar tissue
  • formation of abscesses (pus-filled swellings)
  • small holes or tunnels that develop in tissue and leak a type of lumpy pus

Read more about the symptoms of actinomycosis.

Types of actinomycosis

In theory, actinomycosis can develop almost anywhere inside the tissue of the human body. But the condition tends to affect certain areas of the body and can be classified into four main types.

They are:

  • oral cervicofacial actinomycosis
  • thoracic actinomycosis
  • abdominal actinomycosis
  • pelvic actinomycosis

These are described below.

Oral cervicofacial actinomycosis

Oral cervicofacial actinomycosis is where the infection develops inside the neck, jaw or mouth. In the past, if the condition developed in the jaw it was known as lumpy jaw.

Most cases of oral cervicofacial actinomycosis are caused by dental problems, such as tooth decay or a jaw injury.

Oral cervicofacial actinomycosis is the most common type of actinomycosis, accounting for 50-70% of all cases.

Thoracic actinomycosis

Thoracic actinomycosis is where the infection develops inside the lungs or associated airways.

Most cases of thoracic actinomycosis are thought to be caused by people accidentally inhaling droplets of contaminated fluid into their lungs.

Thoracic actinomycosis accounts for an estimated 15-20% of cases.

Abdominal actinomycosis

Abdominal actinomycosis is where the infection develops inside the abdomen (tummy).

This type of actinomycosis can have a range of potential causes. It can develop as a secondary complication of a more common infection, such as appendicitis, or after accidentally swallowing a foreign object, such as a chicken bone.

Abdominal actinomycosis accounts for an estimated 20% of all cases.

Pelvic actinomycosis

Pelvic actinomycosis is where the infection develops inside the pelvis.

It usually only occurs in women because most cases are caused when the actinomyces bacteria are spread from the female genitals into the pelvis.

Most cases of pelvic actinomycosis are thought to be associated with the long-term use of an intrauterine device (IUD). This type of contraceptive is often known as the coil.

Pelvic actinomycosis usually only occurs if the coil is left in for longer than the manufacturer recommends.

Pelvic actinomycosis accounts for an estimated 10% of all cases.

What causes actinomycosis?

Actinomycosis is caused by a family of bacteria known as actinomycetaceae. In most cases, the bacteria live harmlessly on the lining of the mouth, throat, digestive system and vagina (in women).

The bacteria only pose a problem if the tissue lining becomes damaged by injury or disease, allowing the bacteria to penetrate deeper into the body.

This is potentially serious because these are anaerobic bacteria, which means they thrive in parts of the body where there isn’t much oxygen, such as deep inside body tissues.

However, an advantage of actinomyces bacteria being anaerobic is that they can’t survive outside the human body. This means that actinomycosis isn’t a contagious condition.

Read more about the causes of actinomycosis.

Diagnosing actinomycosis

In its initial stages, actinomycosis can be a challenging condition to diagnose correctly because it shares symptoms with other more common conditions. It’s often only discovered during tests or surgery to check for other conditions.

For example, many cases of actinomycosis are detected when biopsies are carried out to check for cancer. A biopsy is where a small tissue sample is removed so it can be examined under a microscope.

Actinomycosis can usually be more confidently diagnosed in its later stages, after the sinus tracts have appeared in the surface of the skin.

This is because the sulphur granules produced by the sinus tracts during an actinomycosis infection have a distinctive shape that can be identified under a microscope.

Treating actinomycosis

Actinomycosis usually responds well to treatment, which involves taking a long-term course of antibiotics.

Antibiotics

An initial course of antibiotic injections is usually recommended for 2 to 6 weeks, followed by antibiotic tablets for another 6 to 12 months.

A nurse should be able to teach you how to administer antibiotic injections at home so you don’t need to stay in hospital for the duration of the course.

The preferred antibiotics for treating actinomycosis are benzylpenicillin, which is used for the antibiotic injections, and amoxicillin tablets.

In some cases, other bacteria are also present and more than one antibiotic or other antibiotics will need to be given.

Side effects of these antibiotics include:

  • diarrhoea
  • nausea (feeling sick)
  • skin rash
  • increased vulnerability to fungal infections, such as oral thrush (a fungal infection that occurs in the mouth)

If you’re allergic to penicillin, alternative antibiotics such as tetracycline or erythromycin can be used.

Read more about antibiotics.

Surgery

In some cases, minor surgery may be required to repair the damaged tissue and drain pus out of the abscesses.

Complications of actinomycosis

Abscesses that develop as a result of actinomycosis may form in many parts of your body, including your lungs. They can spread easily from one part of your body to another.

If the original site of the infection is located in the skin of your face, it may spread to nearby parts of your body, such as your scalp or ears.

If the original site of the infection is your mouth, it may spread to your tongue, larynx (voicebox), trachea (windpipe) and salivary glands, and the tubes that connect your throat to your nose.

If the infection spreads to your brain, a brain abscess could develop.

Preventing actinomycosis

Most cases of oral actinomycosis occur as a result of poor dental hygiene. This means practising good dental hygiene is the best way to prevent actinomycosis.

Read about preventing tooth decay and dental health for more information and advice about good oral hygiene practices.

[Original article on NHS Choices website]