Nosheen Nabi, Umer Mehmood, Naseer Ahmed.
Actinomycosis, a Rare Cause of Perianal Fistula.
J Islamabad Med Dent Coll Jul ;12(2):147-9.

Perianal fistula (fistula-in-ano) is one of the most common anorectal diseases. It is an abnormal connection between the anal canal and the perianal skin and is lined with granulation tissue. Although benign, the condition can cause significant distress and embarrassment to the patient. Major causes of an anal fistula are clogged anal glands forming anal abscesses. Other, much less common, conditions are infections, trauma and tumors. The treatment of an anal fistula depends on the etiology and location of the fistula. Most fistulas are treated surgically, through a variety of different procedures. Actinomycosis which is a gram positive bacteria can rarely cause perianal fistulas which is difficult to diagnose clinically so can result in mismanagement and recurrences leading to repeated surgeries.

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