Actinomycosis is a subacute-to-chronic bacterial infection caused by filamentous, gram-positive, non–acid-fast, anaerobic-to-microaerophilic bacteria. It is characterized by contiguous spread, suppurative and granulomatous inflammation, and formation of multiple abscesses and sinus tracts that may discharge sulfur granules. The most common clinical forms of actinomycosis are cervicofacial (ie, lumpy jaw), thoracic, and abdominal. In women, pelvic actinomycosis is possible.


Actinomycosis is a rare infection, especially in the United States. Since the infection spreads so slowly, actinomycosis was first thought to be a fungal infection. But bacteria from a family known as Actinomycetaceae causes it. Some of the Actinomyces bacteria in this family include:

  • Actinomyces israelii
  • Actinomyces naeslundii
  • Actinomyces viscosus
  • Actinomyces odontolyticus

These bacteria naturally live in your body cavities like your nose and throat but don’t usually cause infection unless they can break through the protective lining of your body cavities.


Actinomycosis can take a variety of forms. It can also resemble other infections, and even neoplasms, or tumors. It typically features a number of small, interlinked abscesses.

The symptoms depend on the type of actinomycosis, but they may include:

  • swelling and inflammation at the site of the infection
  • tissue damage and scar tissue
  • abscesses, or pus-filled lumps
  • small holes or tunnels in tissue called fistulas that can leak a kind of lumpy pus
  • The severity of symptoms mostly depends on where in the body the infection occurs
  • There may be pain and fever, along with body aches, fatigue and a general feeling of being unwell.


The health care provider will perform a physical exam and ask about your symptoms.

Tests that may be done to check for presence of the bacteria include:

  • Culture of the tissue or fluid
  • Examination of drained fluid under a microscope
  • CT scan of affected areas

Depending on the specific findings, rate residuals as interstitial lung disease, restrictive lung disease, or, when obstructive lung disease is the major residual, as chronic bronchitis (DC 6600).

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