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Revista Archivo Médico de Camagüey

On-line version ISSN 1025-0255


PILA PEREZ, Rafael; ROSALES TORRES, Pedro; PILA PELAEZ, Rafael  and  ARTOLA GONZALEZ, Javier. Actinomycosis of the leg: an infrequent location. AMC [online]. 2014, vol.18, n.4, pp.451-460. ISSN 1025-0255.

Background: acticnomycosis is an uncommon disease which has diminished since the introduction of antibiotics. It can appear in any site of the body but the primary location in the leg is exceptional. Objective: to present the case of a patient with actinomycosis of the skin of the right leg which constitutes the first case reported in the country. Clinical case: a thirty-two-year-old male patient without pathological antecedents of interest that suffered a stabbing injury in the right leg while camping. Two days later, the patient presented a 3-4cm lesion in the mentioned region, as well as a fever of 38oC. The patient went to the doctor who prescribed him an antibiotic and an anti-inflammatory but he did not get better. He went to the emergency service presenting the lesion in worse conditions. The patient underwent multiple exams and only the following were positive: erithrosedimentation rate, C reactive protein, and the culturing that was first positive for staphylococcus aureus and secondly actinomyces israelii was isolated. A histopathological study confirmed the diagnosis of actinomycosis. The patient had to undergo a treatment with penicillin-G, 4 million IU every 6h for four weeks, and surgery.  A month later, a therapeutic treatment with amoxicillin (500 mg), a capsule every 6h for six months, was established. After the treatment, the patient is asymptomatic. Conclusions: this disease should be considered in the differential diagnosis of any nodule, induration or abscess in soft tissues. The definitive diagnosis requires a culturing in a special environment and histopathology as a complement.


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