Five Cases of Pulmonary Actinomycosis

  • Namba Ryoichi
    Department of Internal Medicine, Hitachi General Hospital
  • Ano Satoshi
    Department of Internal Medicine, Hitachi General Hospital:Department of Respiratory Medicine, Tsukuba University
  • Yamamoto Yusuke
    Department of Internal Medicine, Hitachi General Hospital
  • Nawa Takeshi
    Department of Internal Medicine, Hitachi General Hospital

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  • 最近2年間に当院で経験した肺放線菌症5例の臨床的検討

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Background. Although pulmonary actinomycosis has been recognized as a rare disease, reports of this disease have recently begun to increase. Case. Five cases diagnosed with pulmonary actinomycosis at our institution between April 2005 and August 2007. Results. The patients were from 29 to 71 years old, and consisted of 4 men and 1 woman. All cases had bloody sputum. Four of 5 cases also had dental caries or periodontal disease. Chest CT findings showed a mass-like lesion or air-space consolidation accompanied by pleural thickening. Two cases showed cavity formation and 2 cases showed a central low attenuation area within the consolidation, respectively. Pathological or bacteriological diagnosis was confirmed in 4 cases (80%) by bronchoscopy (transbronchial biopsy in 1 case, smear or culture of transbronchial brushing followed by bronchial lavage in 3 cases). Three cases were cured by appropriate antibiotic therapy. One case was cured by surgical resection followed by antibiotic therapy. One patient died of massive hemoptysis and hypoxic encephalopathy. Conclusion. We considered that early bronchoscopic examination of pulmonary abscess plays an important role in establishing a correct diagnosis of pulmonary actinomycosis.

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