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Thoracic Actinomycosis — SCE Infectious Diseases MCQ

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HardRespiratory InfectionThoracic ActinomycosisSCE Infectious Diseases

A mandibular mass crosses tissue planes and drains through chronic sinuses. Histology shows sulphur granules and branching Gram-positive filaments. Which specimen strategy offers the best microbiological yield?

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Correct answer: A — Deep tissue or pus in anaerobic transport for prolonged culture

Actinomyces are commensals and slow-growing anaerobes. Deep tissue or pus, not a superficial sinus swab, should be transported promptly under anaerobic conditions and incubated for long enough; histology is complementary. Growth from saliva or a mucosal swab does not establish tissue invasion.

Reference: Valour et al: Actinomycosis—etiology, clinical features, diagnosis and management: https://pmc.ncbi.nlm.nih.gov/articles/PMC4094581/; UKHSA: Anaerobe Reference Unit, Cardiff: https://www.gov.uk/government/collections/anaerobe-reference-unit-aru-cardiff