Thoracic Actinomycosis

Thoracic actinomycosis: report of a patient with advanced-stage disease

“…Thoracic actinomycosis is generally caused by aspiration of contaminated secretion from the oropharynx or direct extension of cervicofacial or abdominopelvic forms [1,2,4,7,9]. The thoracic disease may also occur by lymphohematogenic dissemination.…”

“…The lower lobes are the most commonly involved. Cough, sputum, fever, weight loss, thoracic pain, hemoptysis, and dyspnea are frequent complaints [2,6,[9][10][11][12].…”

“…Sulphur granules composed by clusters of radiated, filamentous, Grampositive microorganisms are characteristic in compromised tissues. Although the growth of Actinomyces on anaerobic cultures occurs in less than 50% of cases, it is considered the gold standard method for definitive diagnosis [2,4,[6][7][8][9]11,12].…”

A painful and swollen right breast in a young male

“…These causative agents are Gram-positive, pleomorphic and filamentous organisms, found in the normal flora of the oral cavity, gastrointestinal tract and bronchial secretions. It classically involves cervicofacial, abdominopelvic, thoracic and mixed organs, including skin, pericardium, brain and limbs [1,2]. Thoracic actinomycosis (15-20% of all cases) usually involves the lungs, pleura, mediastinum and the chest wall, and is considered a rare infection, particularly in the developed world.…”

“…In this patient, in can also be assumed that the fact that he didn9t present an extensive and destructive lung involvement might be related to the sporadic use of antibiotics for his dental problems. Indeed, actinomycosis may spread from an early pneumonic focus to the pleura, without necessarily causing grossly evident pleural infection, and then extend to the chest wall, ignoring anatomical barriers, and leading to bony destruction [5,6]. No cutaneous draining sinus was evident at admission in the patient.…”