Treatment of Actinomycosis with Penicillin
Two cases of actinomycosis satisfactorily treated with penicillin are reported. Lyons1 reported improvement in 4 cases treated with penicillin but stated that a longer follow-up period was necessary. Herrell2 treated a case of abdominal actinomycosis complicated by carcinoma of the colon with unsatisfactory results. In 3 cases of maxillofacial actinomycosis he considered recovery satisfactory. Florey and Florey3 believed that in their 2 cases dosage was inadequate. Christie and Garrod4 treated a patient with actinomycosis of the chest wall and lung, who subsequently died from infection introduced by penicillin intravenous drip. At autopsy they observed disintegration of the fungus colony, which they believed might have resulted from treatment.
Case 1—The patient was a white woman, aged 44. She was admitted to the hospital in M ay 1944. In January 1943 a supracervical hysterectomy was performed in another hospital. Soon after operation abscesses and multiple fistulas developed. X-ray showed a communication between one fistula in the lower left abdomen and the small bowel and vagina. A second sinus draining from the left iliac region and a third from the lower right chest wall did not communicate with a viscus.
For sixteen months prior to penicillin treatment, the patient had a slight temperature elevation daily, was unable to be out of bed, lost weight, and had no appetite, and the sinus tracts drained pus continually. The pus contained sulfur granules and actinomyces. The patient was hospitalized and during a thirty day period received a total of 2,000,000 units of penicillin. . .