Thorax 1982;37:1861-862 Short reports

Actinomycosis is a worldwide chronic infection caused by an anaerobic Gram-positive organism. The human disease is most commonly caused by Actinomyces israelii, described by Israel in 1878. The organism is a normal commensal ofthe mouthand is found especially in the tonsils and in carious teeth. This endogenous infection is characterised by granulation formation and by fibrous infiltration and may present as a pseudotumour mass. ' Classically there are multiple small, coalescent abscesses with communication sinuses and "sulphur"granules, which when recognised are diagnostic. A normocytic normochromic anaemia is frequently seen.2 Actinomyces is a difficult organism to isolate and the infection is difficult to treat. Treatment consists of surgical drainage of the infected abscesses and administration of antibiotics. Penicillin is the Fig 2 Bronchoscopicphotograph Of tne tracnea. nodular mass on the right lateral tracheal wall. Fig 1 Indurated mass at the root ofthe patient's neck with imminent sinusformation. Address for reprint requests: Mr 0 Maiwand, Colindale Hospital, Colindale Avenue, London NW9 5HG. drug ofchoice, to be given for at least three months; in patients allergic to penicillin clindamycin may be the alternative choice. Intravenous treatment is not necessary.2 To our knowledge, actinomycosis ofthe trachea and supraclavicular region has not been reported previously. Case repor