Pulmonary actinomycosis requiring surgical resection of remaining nodule after antibiotic therapy

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  • 多発肺放線菌症を疑う結節影の抗菌薬投与後遺残の1切除例

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<p>Pulmonary actinomycosis involving multiple nodules is relatively uncommon. We report a case of pulmonary actinomycosis involving multiple nodules requiring surgical resection of the remaining nodules after antibiotic therapy. A 71-year-old man admitted to our hospital for pyothorax was found to have multiple nodules in the right lung on chest computed tomography. Although most nodules disappeared after 2 weeks of antibiotic therapy, a nodule in the right S8 remained and gradually enlarged. We performed partial resection based on a suspected diagnosis of malignancy. As a result of pathological findings, the patient was subsequently diagnosed with pulmonary actinomycosis. It is important to reconsider if the period of antibiotic therapy is adequate when a nodule remains after the others have disappeared and include pulmonary actinomycosis as a differential diagnosis. Moreover, a linear shadow from the nodule to pleura may represent pleural inflammation or the initial image of pleural thickening, leading to suspected pulmonary actinomycosis. Therefore, it should be noted that knowledge of the clinical course and image findings could be helpful for differentiating pulmonary actinomycosis from others.</p>

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