ACTINOMYCOSIS: ITS RECOGNITION AND TREATMENT

Abstract

The clinical course of 37 cases of actinomycosis is presented. The distribution of primary lesions is quite different from that commonly accepted, for abdominal lesions comprised 63%, thoracic lesions 15.13% and cervico-facial lesions 24%. Increased abdominal explorations in cases clinically thought to be carcinoma may account for the increased incidence of abdominal lesions. The concept of endogenous origin of this infection is supported by these cases. In many, there is clear-cut evidence of penetration of a normal mucous membrane. In 4 cases of infection originating in the colon, the cause was perforation by a fish bone, which was found on surgical exploration. The treatment of this disease appears to be wide surgical excision, coupled with prolonged, intensive penicillin therapy. Using this treatment the cure rate for this disease in the Johns Hopkins Hospital has been increased in the last 5 years to 88%.