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Clinical Problem Solving: Pathology
September 2002

Diagnosis Pathology Quiz Case 1

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2002;128(9):1101. doi:

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.