Pulmonary actinomycosis diagnosed by transbronchoscopic lung biopsy: A case report and literature review

Abstract

Pulmonary actinomycosis is a chronic, suppurative, granulomatous disease caused by Actinomyces israelii, an obligate anaerobe. The clinical manifestations and imaging characteristics of pulmonary actinomycosis lack specificity and can lead to confusion with tuberculosis and lung cancer. The present study reported a case of pulmonary actinomycosis diagnosed by transbronchoscopic lung biopsy and reviewed the literature on the disease. The clinical characteristics, signs, laboratory findings as well as progression, diagnosis and treatment in the case of pulmonary actinomycosis were analyzed. The patient was diagnosed by transbronchoscopic lung biopsy. After two weeks of antibiotic therapy, the cough was significantly improved and the patient's temperature returned to normal. Moreover, the lesion in the left lower lung was significantly smaller. Pulmonary actinomycosis is usually confused for tuberculosis and lung cancer. The present findings indicated that transbronchoscopic lung biopsy is a useful tool for diagnosing the disease. To conclude, doctors should have a clear enough understanding of the disease to prescribe empirical antibiotics and avoid unnecessary surgery.

Pulmonary Actinomycosis Complicated by Fistula of the Chest Wall

“…Suzuki et al [7] reported a case where pulmonary actinomycosis was diagnosed by transbronchial lung biopsy, but it is to remember that the diagnosis was made based on the tissue histopathological examination, not the cultures. Ding et al [5] and Tabarsi et al [8] presented similar cases. In our patient, bronchoscopy was not performed because the disease process seemed to originate from the chest wall.…”

“…It may also involve the central nervous system, bones and joints and the genitourinary system [4]. Lung in-fection occurs as a result of aspiration of infected contents from the oral cavity and the gastrointestinal tract [5]. Risk factors include lack of proper oral hygiene, alcoholism, chronic respiratory diseases such as chronic obstructive pulmonary disease, bronchiectasis, history of pulmonary tuberculosis, immunosuppression in the course of other diseases or treatment [4].…”

“…Males are more likely to be affected than females, which may be associated with less hygiene and more frequent facial injuries. Infection can occur at any age, but most often occurs in people aged 20-50 [5]. We present the case of a 43-year-old man suffering from actinomycosis complicated by a fistula of the chest wall.…”

A Rare Bug and Recurrent Bleed

“…Men are twice more affected than women. [ 4 ] Poor oral hygiene, alcoholism, immunosuppressive conditions, diabetes, and underlying structural lung diseases such as emphysema, chronic bronchitis, and bronchiectasis can predispose for infection. [ 5 6 ] They are commensals seen in the mucosal lining of the oropharynx, gastrointestinal tract, and female genitalia.…”

Clinical features of actinomycosis: A 20-year experience of a single institute in Southern China

“…The clinical manifestations and imaging characteristics of pulmonary actinomycosis lack specificity, and can lead to confusion with tuberculosis and lung cancer. This may lead to misdiagnosis of the disease, and hence, incorrect treatment [11]. Cases of musculoskeletal actinomycosis, such as that of the long bones are rare, and are typically described as chronic sclerotic or spherical osteomyelitis [12].…”