Course, Diagnosis, Prognosis. ggQ 



Diagnosis. In doubtful eases the diagnosis of actinomycosis 

 may be confirmed by the demonstration of actinomyces in the 

 tissues or secretions. The fungus colonies which are usually 

 yellowish and of the size of a poppy seed, may be seen bv the 

 unaided eye. Under the microscope, however, they are readily 

 recognized in unstained preparation by their glistening, club- 

 shaped structure (in case of existing calcification treatment 

 with hydrochloric acid is necessary). When stained according 

 to Gram's method the central mycelial mass may be recognized, 

 and in the same manner branching threads of mycelium may 

 be found in the purulent secretion. The presence of the latter 

 is sufficient evidence upon which to base a diagnosis. 



In regard to the differential diagnosis of superficial tumors, 

 sarcomata, lymphomata and botryomycomata are of particular 

 importance. In affection of the tongue, other inflammatory con- 

 ditions of this organ as well as tuberculosis should be kept in 

 mind. The latter disease should also be taken into considera- 

 tion in the occurrence of subcutaneous tumors, although tuber- 

 culous lymph glands usually do not in mature cattle become 

 adherent to the skin, and consequently dO not break open and 

 discharge their contents. There is also no diffuse infiltration of 

 the surrounding tissues in the latter disease. As a matter of 

 fact, however, the clinical pictures of tuberculosis and actino- 

 mycosis, especially in affection of the udder, bones and the 

 lungs have much in common, and a positive differentiation 

 between the two diseases is possible only by an exclusion of the 

 presence of secondary affection of the regional lymph glands 

 as well as the exclusion of similar changes in more remote 

 organs. The positive results of microscopical examination of 

 secretions or tissue masses are of course always final. In 

 regard to other affections of the udder, the differentiating char- 

 acteristics are similar to those referred to under tuberculosis 

 of the udder (see p. 591). The enlargement of the regional 

 lymph glands and the absence of yellowish granules in the secre- 

 tion of the ulcers of the tongue are sufficient to differentiate 

 between actinobacillosis and actinomycosis. 



Prognosis. The prognosis may be considered ^s favorable 

 in those cases in which the seat of the disease is superficial and 

 accessible to surgical treatment. Actinomycomata in the sub- 

 parotideal or cervical regions may in exceptional cases termi- 

 nate in spontaneous recovery (Bang, Jensen). In such cases 

 the tumor becomes encapsuled in tough, fibrous tissue, which 

 checks the further progress of the disease (cicatricial contrac- 

 tions so frequently observed in the tongues of cattle are evi- 

 dently, for the greater part at least, the result of actinomycotic 

 lesions). Since the introduction of the potassium iodide treat- 

 ment for actinomycosis, the prognosis of the affection of the 

 internal organs can be made much more favorable. However, 

 the prognosis of the disease in bones is always unfavorable. 



