Albanian Journal of Trauma and Emergency Surgery (2022) 6/2: 1064-1068 https://doi.org/10.32391/ajtes.v6i2.270 CaSe rePortS Primary Actinomycosis of the Foot in a 37-year-old female Patient: A Case Study and Review of the Literature. Nusret Xhaferi 1 , antonio Gavrilovski 1 , Marija Jakimova 1 , Fatime Ukaj 2 , Dea Dyla 2 , Skender Ukaj 2,3* Received: 11 February 2022 / Accepted: 19 May 2022 / Published online: 20 July 2022 this article is published with open access at https://journal.astes.org.al © The author(s) 2022. & Copyright © 2022, the Albanian Society for Trauma and Emergency Surgery The Albanian Journal of Trauma and Emergency Surgery is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License: http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited. Abstract A parasitic disease called actinomycosis occurs when bacteria spread through body tissues, causing abscesses, infam- mation, and pain. It affects the skin or deeper parts of the body and can sometimes affect the blood.[1] the symptoms of actinomycosis may mimic those of other diseases or even neoplasms. remission and exacerbation of symptoms occurring in parallel sequence with the initiation and cessation of therapy is a phenomenon that should increase suspicion of actinomycosis in any of its manifestations. [2] Microbiology, histopathology, and MrI revealed the presence of an unusual infectious agent, actinomyces spp., which is also known as Madura foot [3] This implies a serious diffculty in getting a bactericidal concentration of the effective drug into areas of active infection and seriously questions the possibility of restoring the involved tissues [4, 8] The diagnosis was confrmed by isolation of the organisms by anaerobic culture giving typical molar tooth colonies. Final confrmation was done by histopathological examination. Case report; The patient’s condition dates back 5 years before the operative treatment when for the frst time the patient reported that she was stabbed with a foreign body in the area of the left foot. the patient was treated at home and in the beginning, did not go to the doctor. She occasionally complained of pain and swelling but the pain was not distressing, with no fever and no swelling of the foot… Keywords: actinomycosis, Foot, Unusual Wounds, Fistula, amputation Original article, no submission or publication in advance or in parallel * Corresponding author: Prof. Skender Ukaj MD, Ph.D. * skender.ukaj@uni-gjk.org 1 Orthopedic Service, University Clinic for Traumatology, Skopje, R North MACEDONIA 2 Department of Orthopedics, University Clinical Center, Pristina, KOSOVO 3 Faculty of Medicine, Gjakova University of “Fehmi Agani”, KOSOVO Introduction: actinomycosis is an indolent, slowly progressive, suppurative infection caused by gram-positive branching bacteria of the genus Actinomyces. the organism is a member of the oral and gastrointestinal microfora of humans. The disease actinomycosis most commonly occurs in 3 body regions: cervicofacial (55% of patients), abdominopelvic (20%), and pulmonothoracic (15%).[2] Involvement of other parts of the body is uncommon and usually secondary to a lesion in one or the other of the above sites. extremity disease can occur by secondary involvement through direct extension or hematogenous spread. However, primary actinomycosis of an extremity is very rare Case report the patient’s condition dates back 5 years before the operative treatment, when for the frst time the patient reported that she was stabbed with a foreign body in the area of the left foot. (Fig.1)