Actinomycosis in childhood: A clinical study and review.

Actinomycosis or infection with the ' ray fungus ' is a relatively rare condition in childhood but is nevertheless of importance in the differential diagnosis of chronic (suppuration following appendicitis and of the chronic inflammatory conditions of the jaws, face, and neck. The pulmonary forms of the disease may simulate lung abscess, empyema necessitatis, or tuberculosis, and owing to the difficulty of making the diagnosis from examination of the sputum, the condition is possibly less rare than is generally supposed. In a collected series of six hundred and seventy cases of actinomycosis of all types occurring in the United States, Sanford and Voelker' include thirty-nine patients under the age of fifteen years. The following study is based on five cases of actinomycosis in children, three personally observed and two (cases I and 2) added from the records of the Hospital for Sick Children. In three of these the infection was primarily abdominal, and in two pulmonary. (Another case, that of a submaxillary abscess, occurring recently in the practice of the Hospital for Sick Children, is not included here but is being reported elsewhere by Mr. Charles Keogh). The autopsy on case 5 was the first to be performed on a patient with actinomycosis in a series of 11,500 autopsies carried out at this hospital.