A 36 year old Malay nurse from a Primary Health Centre presented with a 1 month history of a deep discharging sinus in the right axilla. An excision biopsy was done elsewhere for a lump in the axilla of2 months duration, which was 4 cm long, soft in consistency and tender, especially during menstruation. Post-operatively, the wound did not heal and was exuding purulent discharge. There was no history. of recent dental extraction, tonsillitis or long-standing respiratory problems. DiscIJssion

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... inomyces israelii is often found as a saprophyte in the tonsillar cryps and carious teeth. What causes it to be an invasive pathogen is not known; but immunosuppresion and breakdown of tissue barrier may play a role. Although any organ can be affected, there are 3 main clinical types, namely, cervicofacial, thoracic and Med