LAUSR

DEAR EDITOR, A 45-year-old man presented with painful abscesses and multiple sinus tracts with purulent discharge on the buttocks, thighs and scrotum (a, b), which had persisted for 2 months. His medical history included a 3-year case of mild-to-moderate hidradenitis suppurativa (HS), which was treated with several therapies (clindamycin, sulfamethoxazoletrimethoprim) and surgical excision. The microscopic findings revealed sulfur granules with filamentous Gram-positive bacteria (c). Actinomyces meyeri was isolated. Histological examination showed a granulomatous suppurative process (d, e). The patient was treated with amoxicillin/clavulanate and showed clinical improvement. The association of HS and actinomycosis is exceptional and this was associated with A. meyeri. Actinomyces spp. and other anaerobic microorganisms are part of the HS microbiota and may generate dysbiosis.