Actinomycosis. Presented by Dr. Gerald F. Machacek.
A white boy aged 11 suffered a severe attack of Shigella flexner dysentery at the age of 3½ years. He recovered after several months with supportive treatment and many antibiotics. An infected submental cyst was noted at this time, and it was said to have been present since the age of one year. At the age of 5 years the patient had acute generalized fibrinopurulent peritonitis and bilateral pleural effusion of unknown cause. Exploratory laparotomy failed to reveal the cause of the peritonitis, which was followed by an abdominoperitoneal fistula. Staphylococcus pyogenes var. aureus was cultured from the peritoneal exudate.
After a venous ``cut-down'' an ulcer developed on the left ankle. This healed slowly. Meanwhile, in mid-1954 cervical abscesses appeared, and these have persisted until the present. Pulmonary disease of the right middle lobe and pleura persisted,
Miller JL, Cormia FE. NEW YORK DERMATOLOGICAL SOCIETY. AMA Arch Derm. 1959;79(6):735–740. doi:10.1001/archderm.1959.01560180109033
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