Gluteal primary cutaneus actinomycosis

Abstract

A 58 year old male presented with multiple areas of painless purulent discharge from the buttocks. He had pallor and dermatological examination revealed multiple subcutaneus nodules and discharging sinuses over the buttocks with hyperpigmentation and indurated puckered scarring. Examination of the pus revealed ′sulphur granules′ and Gram stain showed narrow bacillary forms and elongated hyphae with occasional branching. Skin biopsy revealed granular colonies in which ′ray fungus′ were seen. In brain-heart glucose agar in anerobic environment, white spidery colonies of Actinomyces israelii were grown at 37o C in 4 days, confirming primary cutaneus actinomycosis. He was managed with capsule doxycycline with regression of pus discharge in 6 weeks and therapy is planned for 18 months.

Keywords

• Buttocks
• Actinomyces israelii
• Culture