Pulmonary actinomycosis with chest wall fistula formation
ABSTRACT Actinomycosis is a suppurative infection caused by bacteria of the genus actinomyces. It is a rare cause of pulmonary infection and can be difficult to diagnose as its presentation may mimic cancer or tuberculosis. In the absence of treatment of pulmonary lesions fistulae can develop. We report a case of pulmonary actinomycosis complicated by a chest wall fistula that was managed by the thoracic surgery unit at Chu Ibn Sina de Rabat.
A 45 year old man who was previously fit and well presented with a left sided chest wall swelling with cutaneous fistulae. Pulmonary auscultation revealed evidence of left apical consolidation. Otherwise clinical assessment was unremarkable. Plain chest radiology revealed left apical opacification. CT scanning revealed a left pulmonary mass and percutaneous biopsy confirmed the diagnosis of actinomycosis. The patient was started on treatment and experienced a clinical and radiological improvement sustained at one year's follow up.
We review the clinical and radiological characteristics of this condition as well as diagnostic difficulties, histological findings, therapeutic options and its natural history.
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- "In our patient, P. bivia isolated from the chest wall was sensitive to amoxicillin/clavulanate, which was administered postoperatively and achieved satisfactory results. The common infectious agents on the chest wall are Mycobacterium tuberculosis, Actinomyces sp., fungi, and other aerobes and anaerobes (Kuzucu et al., 2004; Herrak et al., 2007; Lin et al., 2007; Luh et al., 2007). Chest wall abscesses caused by P. bivia have not been reported previously. "
ABSTRACT: Prevotella bivia is associated with pelvic inflammatory disease. A 77-year-old man developed a rapidly growing chest wall abscess due to P. bivia within days. He underwent surgical resection of the infected area; his postoperative course was uneventful. This is the first case of chest wall abscess due to P. bivia infection. Its correct diagnosis cannot be underestimated because fulminant infections can occur in aged or immunocompromised patients if treated incorrectly. Prompt, appropriate surgical management, and antibiotic therapy affect treatment outcome.Journal of Zhejiang University SCIENCE B 04/2009; 10(3):233-6. DOI:10.1631/jzus.B0820289 · 1.29 Impact Factor
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ABSTRACT: Thoracic actinomycosis is a rare disease, with high morbidity related to delayed diagnosis. Objectives To identify and analyse paediatric thoracic actinomycosis to promote earlier diagnosis. Design A 10-year descriptive retrospective review (1999–2008). Clinical, biological, and radiological data were collected and compared to identify common signs. Results Three patients were identified. The time to diagnosis varied from 4 months to 3 years. Fever, asthenia, pain, weight loss, and sweats were the most common complaints. A predisposing factor was systematically observed. Irregular subpleural nodules were revealed with an infiltrative aspect. Definitive diagnosis was always histological. Conclusion Actinomycosis should be sought in patients with asthenia and weight loss, local pain, when chest radiological evidence of distal nodules is observed with a non-specific biologic inflammatory syndrome. At this time, anaerobic bacteriological tests and histology should be performed.Archives de Pédiatrie 05/2011; 18(5):558-561. DOI:10.1016/j.arcped.2011.02.023 · 0.41 Impact Factor
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ABSTRACT: Introduction. Actinomycosis is a suppurative infection caused by bacteria of the Actinomyces genus. It is a rare cause of pulmonary infection and can be difficult to diagnose because its presentation may mimic tuberculosis or cancer. In the absence of treatment of pulmonary lesions fistulae can develop. We report a case of thoracic actinomycosis with chest wall involvement in a child, managed in the pediatric department at Moulay Youssef University Hospital in Rabat, Morocco. Case report. We report the case of a 13-year-old boy with a history of trauma to the right chest 1 year earlier, admitted with right-sided chest wall swelling with cutaneous fistulae. Physical examination identified a parietal mass with fistulization to the skin. Laboratory tests showed an inflammatory syndrome. The chest x-ray revealed moderate right pleural effusion. The thoracic computed tomography scan showed a right parietal pleural mass and the percutaneous biopsy confirmed the diagnosis of actinomycosis. The patient underwent antibiotic therapy with favorable evolution. Conclusion. The diagnosis, the clinical, radiological and histological pattern, and the therapeutic features are described in this report.Archives de Pédiatrie 06/2014; 21(7). DOI:10.1016/j.arcped.2014.04.013 · 0.41 Impact Factor