A Case of Thoracic Actinomycosis with Hemoptysis Successfully Treated by Bronchial Artery Embolization

DOI 15 References
  • Nikaido Takefumi
    Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
  • Tanino Yoshinori
    Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
  • Minemura Hiroyuki
    Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
  • Yokouchi Hiroshi
    Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
  • Miyazaki Makoto
    Department of Radiology, Fukushima Medical University School of Medicine
  • Fukuhara Atsuro
    Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
  • Sekine Satoko
    Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
  • Sato Suguru
    Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
  • Kanazawa Kenya
    Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
  • Ishida Takashi
    Department of Pulmonary Medicine, Fukushima Medical University School of Medicine
  • Munakata Mitsuru
    Department of Pulmonary Medicine, Fukushima Medical University School of Medicine

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Other Title
  • 喀血に対し気管支動脈塞栓術が有効であった肺放線菌症の1例

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Abstract

Background. Pulmonary actinomycosis is a chronic suppurative granulomatous disease caused by oral anaerobic Actinomyses spp. Because it is difficult to diagnose pulmonary actinomycosis by bronchoscopic biopsy or culture, the diagnosis is often made after surgical resection, especially in cases with hemoptysis. Case. A 40-year-old man was referred to our hospital because of a 2-year history of hemoptysis and increased size of a solitary shadow on a chest radiograph which had been followed up for 2 years. Computed tomography revealed a tumor with a cavity in the right upper lobe. Fiberoptic bronchoscopy was performed, and showed a proximal ulcerative lesion in the right B^2b. We diagnosed actinomycosis by histopathological findings of the transbronchial biopsy specimen. Because hemoptysis continued in spite of 20-day antibiotic therapy by ampicillin, and a bronchial arteriogram showed bronchial artery pulmonary artery shunt (BP shunt), bronchial artery embolization was performed. After the procedure, hemoptysis completely disappeared, and the antibiotic therapy was continued. After one month, the antibiotic was changed to oral amoxicillin, and the patient was discharged. Conclusion. Although surgical treatment is usually performed for hemoptysis from thoracic actinomycosis, bronchial artery embolization with prolonged penicillin therapy is another treatment option.

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