This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Trauma, Subject name: Surgery
Multiple sinuses and induration of chest wall is likely due to 
Select and explain. 
A. Tuberculosis, B. Atypical mycobacterial infection, C. HIV-AIDS patient with tuberculosis, D. Pulmonary actinomycosis
D: Pulmonary actinomycosis
Answer: D: Pulmonary actinomycosis 
Explanation: Pulmonary Actinomycosis. Lung and pleura get infected by direct spread from pharynx or by aspiration. Empyema develops. Later chest wall nodules appear leading to sinuses with discharge(20%). Fascio-cervical type is the most common Reference : SRB's Manual of Surgery, 6th Edition, page no = 54.