A Case of Obstruction Pneumonia with Broncholithiasis from Endobronchial Actinomycosis

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  • 気管支放線菌症が成因と考えられる気管支結石により閉塞性肺炎を呈した1例

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Abstract

<p>Background. While broncholithiasis is a rare disease, we should consider its possibility if calcification is observed. Case. We herein report a 76-year-old man who required tracheostomy and gastrostomy after subarachnoid hemorrhaging and leg amputation for arteriosclerosis obliterans. The patient had been diagnosed with right empyema at another hospital and referred to our hospital for treatment. At our hospital, the patient was diagnosed with obstruction pneumonia with a calcified foreign body using computed tomography. We planned to remove the calcified foreign body using bronchoscopy at the right inferior lobar bronchus. Bronchoscopy revealed a yellow-white broncholithiasis that was subsequently removed. On histopathology, the foreign body was found to be a bacterial colony with calcification and diagnosed as endobronchial actinomycosis using Gram, Grocott, and Fite method (positive Gram and Grocott staining but negative Fite method). After 3 weeks, the patient was transferred to his previous hospital because of improvement in his condition. Conclusion. If a compromised patient is diagnosed with obstruction pneumonia with a calcified foreign body, we should suspect the existence of infection caused by indigenous bacteria in the oral cavity, such as actinomycosis.</p>

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