Pulmonary actinomycosis with chest wall fistula formation

Centre Hospitalier Universaitaire IBN Sina de Rabat, Rabat, Rabat-Salé-Zemmour-Zaër, Morocco
Revue des Maladies Respiratoires (Impact Factor: 0.62). 04/2007; 24(3 Pt 1):349-52. DOI: 10.1019/20064227
Source: PubMed


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. "
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    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 · 1.28 Impact Factor
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    ABSTRACT: Pulmonary actinomycosis is a rare bacteriological disease, caracterized by local suppuration and an extensive fibroinflammatory process, with a possible pseudotumoral outcome. To report a new observation of a pulmonary actinomycosis. A 52-year-old patient, smoker, admitted in our department for infectious pneumopathy complicated by purulent pleurisy. Clinical and radiological findings were not contributive.Fiberoptic had evocate the diagnosis of bronchopulmonary cancer. Evolution had been marqued by abondant hemoptysia indicating right low lobectomie. The diagnosis of actinomycosis was obtained by the pathology of the surgical resection. Diagnosis of pulmonary actinomycosis can be difficult because it can mimic the presentation of lung carcinoma.If the diagnosis is no late established, and if the patient is correctely treated medically, the prognosis still excellent.
    La Tunisie médicale 04/2011; 89(4):386-90.
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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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