A patient appeared in the emergency room with a submandibular mass. A smear was made of the drainage and a bewildering variety of bacteria were seen, including branched, Gram-positive rods. The most clinically appropriate action is
The patient has actinomycosis. These laboratory data are not uncommon. There is no reason to work up all the contaminating bacteria. A fluorescent microscopy test for A. israelii is available. If positive, the FA provides a rapid diagnosis. In any event, it may be impossible to recover A. israelii from such a specimen. High-dose penicillin has been used to treat actinomycosis.