Primary Cutaneous Actinomycosis

Abstract

<h3>To the Editor:—</h3> Primary cutaneous actinomycosis is a rarity in an uncommon disease. It may be diagnosed only when the presence of a deeper focus has been excluded. Most cases reported have been the result of oral-cutaneous contact. This paper reports an extensive abdominal-wall lesion following a puncture injury with a baling wire. A 42-year-old white man entered the hospital because of multiple draining sinuses over the left abdominal wall. The first lesion had begun a year before as a single, persistent, draining sinus in the left upper quadrant of the abdomen. Three short courses of penicillin in the year preceding admission had each resulted in temporary improvement but drainage recurred and new sinuses formed when treatment was stopped. The patient had been a road-construction laborer. His job was to break open bales of straw and spread it over newly set concrete. He recalled abrading the skin of his abdomen