Intra-abdominal actinomycosis presenting with sulfur granules in the urine

Intra-abdominal actinomycosis is rarely suspected and is difficult to diagnose. A 46-year-old woman with intra-abdominal actinomycosis is described in whom the condition was first suspected when sulfur granules were found in her urine. The infection had involved her bladder but not her kidneys.