[Disseminated actinomycosis presenting with multiple subcutaneous abscesses (author's transl)].

The case report describes a patient hospitalized for multiple subcutaneous abscesses who presented a four-year history of recurrent skin lesions and a fifteen-year history of non specific bronchopulmonary infections requiring segmental resection. The diagnosis of actinomycosis, A. israeli species, was established by culture of surgical drainage material from a thoraco-abdominal wall abscess. Muscle and bone involvement of the right thigh was subsequently demonstrated. There was no evidence of pulmonary infection at the time of hospitalization. Treatment with Penicillin G was curative. A review of the literature is presented together with a summary of thirteen reported cases. Although disseminated actinomycosis has become very rare since the introduction of antibiotic therapy, patients share similar features and a common clinical pattern which are highly evocative of the disease. All patients described had preceding pleuropulmonary disease, characteristically chronic. Evolution of cutaneous lesions was subacute or chronic. In all cases, there was significant delay (months to years) between the initial appearance of skin lesions and subsequent diagnosis. In most cases, actinomycosis had not been suspected. Diagnosis was usually established by isolation and identification of the micro-organism in cultures of purulent material obtained from cutaneous lesions. Despite the probability of hematogenous disease dissemination, pleuro-pulmonary foci were only rarely demonstrated. Prolonged antibiotic therapy was curative in all treated cases.