Pulmonary actinomycosis and skin sinuses

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Dermatology

Background:

• Actinomycosis is a rare bacterial infection caused by Gram-positive, anaerobic, filamentous bacteria.
• It can manifest in various forms, often mimicking other conditions, making diagnosis challenging.

Observation:

• A 12-year-old female presented with a year-long history of recurrent, discharging skin sinuses on her chest wall.
• Concurrent findings included ipsilateral lower lobe pneumonia and bilateral lumbar muscle abscesses.

Findings:

• Aspiration of purulent fluid from the lumbar abscesses revealed characteristic sulfur granules.
• Histological examination confirmed the presence of Gram-positive, branched filaments, indicative of Actinomyces species.

Implications:

• This case underscores the importance of considering actinomycosis in the differential diagnosis of complex skin and soft tissue infections, especially with pulmonary involvement.
• Successful treatment with penicillin and doxycycline highlights the efficacy of standard antibiotic regimens for actinomycosis.