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Actinomycotic infections are very rare. The lowering of the incidence is related to the widespread use of antibiotics and improved oral hygiene.1 The present case revealed a characteristic picture of sulfur granules on a hematoxylin-eosin–stained section. Gram-positive branching and filamentous bacilli within the granules were demonstrated on gram and Gomori methenamine silver stains. Although Nocardia should be considered, the absence of any acid-fast staining was helpful in excluding this infectious agent from the differential diagnosis. The histopathological diagnosis of actinomycosis was thus confirmed, even though the anaerobic culture proved to be negative.
Diagnosis Pathology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2002;128(9):1101. doi:
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