The stomach is a rare site for Actinomyces to gain a primary foothold. While the fungus is known to be of relatively low pathogenicity, once a port of entry is established the infection is very tenacious, and a granulomatous lesion results. Intestinal actinomycosis is well known. Two factors could be conducive to its relatively frequent occurrence in the appendix and the large intestine: stasis, and the common presence of mucosal imperfections. The stomach offers only one of these conditions commonly—mucosal defects. Hypothetically, the most favorable circumstances for the development of gastric actinomycosis might be the simultaneous presence of mucosal defects and viable Actinomyces in the stomach content or the production of mucosal defects by the ingestion of infected roughage.
The literature contains few case reports of primary gastric
Fuller CC, Wood H. ACTINOMYCOTIC GRANULOMA OF THE STOMACH. JAMA. 1945;129(17):1163–1165. doi:10.1001/jama.1945.92860510003009
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