A 35-year-old male farmer presents with multiple discharging cervical sinuses. Which of these stains will be useful for the diagnosis? Where does this organism normally colonise in the body?
Grocott Methenamine silver, skin
PAS, intestine
AFB, mouth
Gram-stain, oropharynx
Ans: C. AFB, mouth(Ref Ananthanarayan 10/e p398, 8/e p391-391' I larrison 19/e p1088)In this farmer, who presented with multiple discharging cervical sinuses, the most likely diagnosis is actinomycosis.Actinomyces - Not acid-fast organism.Actinomycosis:Occurs most commonly at an oral, cervical, or facial site, usually as a soft tissue swelling, abscess, or mass lesion that is often mistaken fir a neoplasm.The angle of the jaw is generally involved, but a diagnosis of actinomycosis should be considered with any mass lesion or relapsing infection in the head and neck.