Evaluation of actinomycosis begins with a history and physical examination.

Physical findings in those with a face or neck infection may include:

• Swelling, redness and tenderness

Physical findings in those with a lung infection include:

• Cough
• Difficulty breathing
• Coughing up mucus
• Coughing blood

Tests are necessary to make the diagnosis of actinomycosis. Testing for actinomycosis depends on the location of the infection.

Testing for actinomycosis may include:

• Chest x-ray: may show cavitary lesions from a lung infection
• Normal chest x-rays
• Chest x-ray showing lung abscess
• Sputum culture
• Complete blood count
• Bronchoscopy
• CT scanning of the chest
• Neck CT scanning
• The diagnosis is confirmed by microscopic examination and culture of the fluid from the lungs, or from an abscess.