Sulfur Granules

Abstract
Actinomycosis is a chronic suppurative infection classically involving the cervicofacial, abdominal, or thoracic regions. Although usually confined to one anatomical area, it may spread contiguously and lead to multiple sinus-tract formations.1Actinomyces israeli, a common saprophyte of the oral cavity, is the causative organism in the human form of the disease. An anaerobic or microaerophilic branching fungus, it is morphologically identical to the aerobicActinomyces, Nocardia asteroides.2Even after Waksman and Henrici3clarified the bacteriology of the two organisms, subsequent reviewers of both actinomycosis and nocardiosis have included conditions diagnosed on morphological grounds alone.4,5Identification is of more than academic interest, since the two organisms have generally distinct antibiotic sensitivities.6Nocardia asteroidesresponds best to sulfonamides andA israelito penicillin. Clinically, actinomycotic infections have been distinguished from nocardial infections by the following criteria: First,A israeliis reported to form sulfur granules. Second, the

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