Actinomycosis is a chronic disease characterized by abscess formation, tissue fibrosis, draining sinuses and ulcers caused by the filamentous, gram-positive anaerobic or microaerophilic bacterial species of the genus Actinomyces. Actinomycosis mainly presents in three forms namely cervicofacial (31-65%), abdominopelvic (20-36%) and thoracic (15-30%) respectively. Primary gastric actinomycosis is extremely rare, with only 24 cases reported till date. We present a case report of a thirty five years old female patient who was admitted in a super specialty hospital with complaints of low grade intermittent fever, abdominal pain and two discharging sinuses on anterior abdominal wall. Clinical, radiological, microbiological and pathological evaluation revealed findings suggestive of primary gastric actinomycosis with underlying gastric adenocarcinoma in this patient. To the best of our knowledge, this is the first ever report of primary gastric actinomycosis from India.
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