Cutaneous Actinomycosis

1. was involved in a motor vehicle collision

2. lesions on his left knee

2.1. left knee was noted to have edema, erythema, hyperpigmentation, hyperkeratinization, and several indurated nodules with scabs and sinus tracts

3. reported no fevers or other systemic symptoms

4. underwent surgery with débridement

4.1. intraoperative cultures grew actinomyces species

4.1.1. finding that was corroborated by histologic examination

5. treated with amoxicillin–clavulanic acid, administered orally for 1 year

5.1. had clinical improvement but not full resolution

6. 33-year-old man

7. skin thickening and several subcutaneous nodules smaller

7.1. had gradually developed on the medial and lateral sides of his knee

7.2. had subsequently disseminated to the thigh