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A 39-year-old man was admitted to our hospital in January, 1979. His chief complaint was multiple subcutaneous abscesses with a violet red colored, board-like rigidity and sinuses in the back, buttock and lower extrimities. The lesions gradually developed since he had received wounds in the back in a traffic accident about two years before. At exploration, violet pus with "sulfur granules" was obtained. Gram positive branching filaments and rods were detected in smears of the granules. Anaerobic culture of the pus and of the granules yielded colonies abundant in gram positive, non acid-fast bacilli. We suspected them of Actinomyces. He was healthy generally and orodentally. The chest X-ray and barium enema were normal. The diagnosis of primary cutaneous actinomycosis was made. Shortly after admission, chemotherapy was commenced with intramuscular penicillin G, intravenous and oral ampicillin and oral sulfisomezole. Approximately six months of continued treatment primarily with penicillin brought about a perfect cure. Primary cutaneous actinomycosis is an extremely rare disease. It can be diagnos d only when the possibility of presence of a deeper focus has been excluded. Searce cases of the disease were mostly reported in Europe and North America.
日本医真菌学会の論文