Thoracic Actinomycosis

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Abstract
Three of six patients with thoracic actinomycosis had dissemination to skin, subcutaneous tissue, and muscle. These peripheral lesions were a presenting or prominent sign in all three cases. The presence of sulfur granules in the drainage from an open lesion or in the aspirate from a fluctuant mass, and the finding of Gram-positive filaments on Gram stain led to the diagnosis. Definite diagnosis was made by isolatingActinomyces israeliby anaerobic culture. The occurrence of dissemination in thoracic actinomycosis may be more frequent than previously reported. The roentgenographic finding of a pulmonary infiltrate in association with multiple peripheral lesions involving skin, subcutaneous tissue, and muscle—as illustrated in our three cases— presents a fairly typical clinical picture that should suggest the presence of this infection.

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