Case Of Pulmonary Actinomycosis Research Articles

Two cases of pulmonary actinomycosis diagnosed after surgical resection

Two cases of pulmonary actinomycosis diagnosed after surgical resection

Een bacterie vermomd als schimmel: pulmonale actinomycose bij een geriatrische patiënte

A bacteria masked as a fungus: a case of pulmonary actinomycosis in a geriatric patient Pulmonary actinomycosis is a relatively rare diagnosis which probably results from the aspiration of oropharyngeal or gastrointestinal secretions. Individuals with aspiration, alcoholism, poor oral hygiene, chronic obstructive lung disease and a decreased immune response are at risk. The most common symptoms are nonspecific and often present late. The imaging of pulmonary actinomycosis is not specific. Therefore, the disease is frequently confused with a malignancy or tuberculosis. The gold standard for the diagnosis is a histological examination and bacterial culture of a lung biopsy. Its treatment requires high doses of penicillin during at least 3 months. In this article, the case of an 82-year-old patient with malaise but without any respiratory complaints is presented. Further examination revealed inflammatory blood signs, as well as infiltration of the right upper lobe on a CT scan of the thorax. To exclude an underlying malignancy, a bronchoscopy was performed. Gram staining of the bronchoalveolar washing showed gram-positive branching rods suspicious for Actinomyces species. Histological examination confirmed the diagnosis of pulmonary actinomycosis. By means of an antibiotic treatment with amoxicillin the patient recovered both clinically and biochemically.

A Rare Case of Pulmonary Actinomycosis Presented With Hollow Mass Lesion and Elevated CEA Level

A Rare Case of Pulmonary Actinomycosis Presented With Hollow Mass Lesion and Elevated CEA Level

A Case of Pulmonary Actinomycosis that was Difficult to Differentiate from Primary Lung Cancer Preoperatively

A Case of Pulmonary Actinomycosis that was Difficult to Differentiate from Primary Lung Cancer Preoperatively

Pulmonary actinomycosis mimicking a lung metastasis from esophageal cancer; a case report

BackgroundActinomycosis is a rare bacterial infection caused by Actinomyces. The symptom of actinomycosis is nonspecific and radiological images present as a slow-progressive mass lesion similarly to malignancies. Thus, it is difficult to distinguish pulmonary actinomycosis from malignancies.Case presentationA 74-year-old male who had esophageal cancer and a pulmonary mass that was positive for 18F–fluorodeoxyglucose positron emission tomography/computed tomography was initially diagnosed with esophageal cancer with a lung metastasis because he was asymptomatic. However, aspiration of pleural effusion revealed that the pulmonary lesion was actinomycosis.ConclusionWe present a case of pulmonary actinomycosis mimicking a lung metastasis from esophageal cancer. Diagnosis of asymptomatic pulmonary actinomycosis is difficult, and needle aspiration could be useful for a definitive diagnosis of pulmonary actinomycosis.

放線菌感染を合併した限局性囊状気管支拡張症の1手術例

症例は77歳，女性．右肺S9bに空洞病変を指摘され，1年前に2回の大量喀血を発症して，気管支動脈塞栓（BAE）を施行されたが，再度大量喀血を発症した．CTでは空洞壁が肥厚化してPET-CTで集積を認め，真菌感染症や抗酸菌感染症が否定的であったことから，肺癌を疑い出血コントロールのため肺葉切除を施行した．摘出肺の空洞はB9気管支と連続し，病理報告では空洞壁は気管支上皮で覆われた限局性囊状気管支拡張症であった．また，内腔には放線菌の細菌塊が認められた．本症例の喀血の原因は，気管支拡張症だけではなく，放線菌の感染も一因であると考えられた．拡張した気管支内に放線菌が確認された報告はあるが，末梢の孤立性の囊状気管支拡張症の中に放線菌が認められた症例は報告されていない．空洞性病変で出血がある場合，放線菌感染を伴う気管支拡張症も鑑別診断の一つとして検討しなければならないと考えられた．

長期経過により荒蕪肺へ移行した肺放線菌症の1切除例

長期経過により荒蕪肺へ移行した肺放線菌症の1切除例

A Case of Pulmonary Actinomycosis with Bronchopleural Fistula

A Case of Pulmonary Actinomycosis with Bronchopleural Fistula

喀血で発症し，アスペルギルス症との鑑別が困難であった肺放線菌症の1切除例

症例は50歳の女性．既往歴として2型糖尿病を有していた．繰り返す喀血を主訴に近医より当科紹介となった．血液検査では炎症反応高値でアスペルギルス抗原が陽性．CTでは空洞を伴う腫瘤を認めた．慢性壊死性肺アスペルギルス症を疑って抗真菌薬を投与するも喀血が改善せず，手術を施行した．摘出標本の病理学的検索にて肺放線菌症と診断した．アスペルギルス菌体は認めなかった．術後は1年間ペニシリン剤の投与を続けた．術後4年を経過した現在，再燃なく経過している．肺放線菌症は比較的稀な疾患であり，肺癌，肺結核，肺真菌症との鑑別が困難な場合が多い．本例のように喀血を初発症状とする症例もあり，喀血を伴う肺の腫瘤状陰影を認める場合は，本症も念頭に置き，可及的早期に診断的治療を開始すべきであると考えられた．

魚骨と考えられる気管支異物による肺放線菌症の1例

魚骨と考えられる気管支異物による肺放線菌症の1例

A Case of Pulmonary Actinomycosis with Recurrent Bloody Sputum Treated by Surgical Excision

A Case of Pulmonary Actinomycosis with Recurrent Bloody Sputum Treated by Surgical Excision

悪性リンパ腫に対する化学療法中に徐々に増大し肺癌との鑑別に苦慮した肺放線菌症の一例

症例は63歳の男性．3年前に他院で左肺上葉の腫瘤影を指摘されていたが，経気管支鏡的生検で悪性所見を認めなかったため経過観察されていた．2年前に瀘胞性リンパ腫を発症し，当院血液内科で半年に渡り化学療法が施行された．指摘されていた左肺上葉の腫瘤は半年の化学療法期間を含む約2年の経過で徐々に増大した．FDG-PET検査では肺癌に特徴的な集積所見を認めたため，原発性肺癌が否定しきれず，左肺切除術を施行した．病理組織検査では肺放線菌症と診断された．悪性リンパ腫に対する化学療法を施行した免疫抑制状態での肺放線菌症の経過を追った報告は稀であるため報告する．

Pulmonary Actinomycosis Caused by <i>Actinomyces cardiffensis</i>

We herein present the first case of pulmonary actinomycosis caused by Actinomyces cardiffensis (A. cardiffensis). A computed tomography (CT) examination revealed a nodule with cavitation in the left upper lobe of the lung. One month later, the lesion had almost disappeared, but a new nodule with peripheral consolidation had appeared in the right middle lobe. Because organizing pneumonia was suspected, prednisolone was begun and improvement was seen. However, two months after the initiation of corticosteroid administration, a chest CT scan showed a lung abscess. The patient underwent surgical resection of the abscess. A. cardiffensis was identified by an amplified 16S ribosomal DNA restriction analysis of a pus sample.

術前精査で組織学的に扁平上皮癌が疑われた肺放線菌症の1手術例

81歳男性．咳嗽，血痰，胸部X線異常影により当院を紹介受診．CTで右肺S6-10に空洞を伴う不整な腫瘤影を認め，気管支鏡検査でB6の不整な粘膜組織から扁平上皮癌を疑わせる細胞を検出し，cT2aN0M0 stage IBの原発性肺癌の疑いで右肺中下葉切除を実施した．術後病理診断では腫瘤は肺放線菌症で，B6気管支上皮には高度異形成を認めた．肺放線菌症は比較的稀で，特異的画像所見もなく確定診断が困難なため，肺癌を疑い手術切除されてから診断に至ることが多い．しかし内科的治療が奏効しやすいため，高齢者や低肺機能症例では手術回避を目指し術前に両者を鑑別する努力が必要で，生検組織の診断においては悪性組織と炎症による高度異形成の鑑別が重要である．また肺癌が合併した放線菌症例もあり，内科的治療の効果によっては再度精査し，外科的切除を検討実施する必要がある．

左肺全摘術を行った肺放線菌症の１例

左肺全摘術を行った肺放線菌症の１例

Pulmonary actinomycosis in fine needle aspiration cytology

Pulmonary actinomycosis is a rare bacterial lung disease caused by one of two types of bacteria, Actinomyces or Propioni. Pulmonary actinomycosis in the lung causes lung cavities, lung nodules, and pleural effusion. We report here a case of pulmonary actinomycosis that was diagnosed by fine needle aspiration cytology (FNAC). A 45 year-old male with a history of smoking and alcohol abuse, presented with complaints of cough with hemoptysis, right-sided chest pain, and fever of two months’ duration. A chest radiograph and computed tomography (CT) of the thorax showed a right upper lobe mass lesion with hilar lymphadenopathy. CT-guided FNAC revealed colonies of Actinomyces surrounded by polymorphs. The disease is commonly confused with other chronic suppurative lung diseases and malignancy. An early diagnosis by FNAC prevents difficulties in the management of the disease, as well as considerable physiological and physical morbidity, including unwarranted surgery.

Five Cases of Pulmonary Actinomycosis

Five Cases of Pulmonary Actinomycosis

A Case of Pulmonary Actinomycosis with Drusen Diagnosed by Ultra-thin Bronchoscope

A Case of Pulmonary Actinomycosis with Drusen Diagnosed by Ultra-thin Bronchoscope

Pulmonary actinomycosis in two chamois (Rupicapra rupicapra)

Actinomycosis is a widespread non-contagious infectious condition, occurring both in animals and humans, caused by bacteria of the Actinomyces genus. In this report, two cases of pulmonary actinomycosis occurring in two wild chamois from northern Italy are described. In both cases, evidence of lung pyogranulomatous lesions with intra-lesional sulphur granules composed of filamentous, acid fast negative bacteria that stain positive for gram and periodic acid Schiff (PAS) leads to the etiological confirmation of pulmonary actinomycosis.

Three Cases of Pulmonary Actinomycosis Diagnosed by Fiberoptic Bronchoscopy

Three Cases of Pulmonary Actinomycosis Diagnosed by Fiberoptic Bronchoscopy