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Primary mammary actinomycosis challenged with penicillin allergy
  1. Josephine B de Leoz,
  2. Devi Suravajjala,
  3. Hashmi Rafeek and
  4. Vani Selvan
  1. Family and Community Medicine, Texas Tech University Health Sciences Center School of Medicine Permian Basin, Odessa, Texas, USA
  1. Correspondence to Dr Vani Selvan; vani.selvan{at}


Actinomycosis is a subacute-to-chronic bacterial infection caused by gram-positive, filamentous, non-acid-fast, facultative anaerobic bacteria. It is a normal commensal bacterium found in the oral cavity and the lower reproductive tract of women. We present a case of primary actinomycosis of the breast. A postmenopausal woman, complicated by penicillin allergy, presented with a left breast lump clinically simulating malignancy. The first line of treatment for actinomycosis is penicillin. Due to a penicillin allergy, the patient was initially treated with doxycycline. However, doxycycline was discontinued due to tremors, and was replaced by clindamycin. The patient had a good clinical response with resolution of the abscess.

  • general practice / family medicine
  • drugs: infectious diseases
  • ultrasonography
  • breast cancer
  • general surgery

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  • Contributors JBdL, DS, HR, VS, literature search, analysis/interpretation of the data,drafting of the manuscript, revising the manuscript for important intellectual content, approval of the last version of the manuscript, submission of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.