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Actinomycotic osteomyelitis in a child

Contrary to what used to be the case, actinomycosis is now a rare disease and only infrequently mentioned in otolaryngological textbooks (Ballantyne, J. and Groves, J. 1979). The disease is a chronic suppurative infection caused by micro-organisms from the actinomyces group, most often israelii. Actinomyces species are all oral commensals. They are gram-positive, non acid-fast, anaerobic or microaerophilic filamentous bacteria (Walker et al., 1981; Bennhoff, 1984). Associated flora of both aerobic and anaerobic bacteria are always present, most frequently anaerobic streptococci, fusiform or gram-negative bacilli, and hemophilus species. The associated flora form a kind of symbiosis with the actinomyces species and may cause an anaerobic environment which furthers the growth of these species (Bennhoff, 1984). Topographically, a distinction is made between 3 favorite localizations: 1. Cervico-facial (55 per cent); 2. Abdomino-pelvic (20 per cent); and 3. Pulmo-thoracic (15 per cent).