{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T23:48:08Z","timestamp":1788479288038,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Actinomycosis is a rare, chronic, and slow\u2010progressing bacterial infection caused by\n                    <jats:italic>Actinomyces species<\/jats:italic>\n                    . The condition's rarity, nonspecific clinical symptoms, and occasional occurrence in atypical locations often lead to delays in diagnosis, which are critical for initiating timely treatment and preventing further complications. We report the case of an 82\u2010year\u2010old man who initially developed pustules on the dorsum of his left hand, which gradually progressed over 15\u2009years into an exophytic mass. Histopathological examination and culture confirmed Actinomycosis, and imaging studies revealed osteomyelitis affecting the carpal and metacarpal bones of the involved hand. Although the delayed diagnosis and treatment resulted in severe osteomyelitis, the patient responded favorably to a combination therapy of Amoxicillin and Trimethoprim\u2010Sulfamethoxazole.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.70298","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T22:34:00Z","timestamp":1741732440000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Primary\n                    <i>Actinomyces<\/i>\n                    in Hand: An Unusual Cause of Osteomyelitis"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7324-0347","authenticated-orcid":false,"given":"Saman","family":"Al\u2010Zahawi","sequence":"first","affiliation":[{"name":"Department of Dermatology Razi Hospital, Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Ghanadan","sequence":"additional","affiliation":[{"name":"Department of Dermatopathology Razi Hospital, Tehran University of Medical Sciences (TUMS)  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0821-7557","authenticated-orcid":false,"given":"Alireza","family":"Hadizadeh","sequence":"additional","affiliation":[{"name":"Female Pelvic Medicine and Reconstructive Surgery, Division of Urogynecology University of Chicago, Northshore University Health System  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faeze","family":"Salahshour","sequence":"additional","affiliation":[{"name":"Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6777-5930","authenticated-orcid":false,"given":"Ali Reza","family":"Khosravi","sequence":"additional","affiliation":[{"name":"Faculty of Veterinary Medicine University of Tehran  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1930-172X","authenticated-orcid":false,"given":"Zahra","family":"Saffarian","sequence":"additional","affiliation":[{"name":"Department of Dermatology Razi Hospital, Tehran University of Medical Sciences  Tehran Iran"},{"name":"Department of Dermatology Imam Khomeini Hospital Complex, Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.922601"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/2277-9175.145700"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2006.06.009"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/ams.ams_176_18"},{"key":"e_1_2_11_6_1","first-page":"183","article-title":"Actinomycosis: Etiology, Clinical Features, Diagnosis, Treatment, and Management","volume":"7","author":"Valour F.","year":"2014","journal-title":"Infection and Drug Resistance"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-005-0030-0"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/0377-4929.174852"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/000992288502401113"},{"key":"e_1_2_11_10_1","volume-title":"Actinomycosis","author":"Sharma S.","year":"2018"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0072-968X(82)80017-X"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1988.00380120112022"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010019\u20102576\u20102"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.19.00520"}],"container-title":["Clinical Case 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