open access

Vol 89, No 5 (2021)
Research paper
Submitted: 2021-02-10
Accepted: 2021-03-30
Published online: 2021-07-16
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Pulmonary actinomycosis complicated by fistula of the chest wall

Ewa Łyżwa1, Izabela Siemion-Szcześniak1, Małgorzata Sobiecka1, Aneta Kacprzak1, Agnieszka Winiarska2, Małgorzata Szołkowska3, Krzysztof Karuś4, Witold Tomkowski1
DOI: 10.5603/ARM.a2021.0071
·
Pubmed: 34269403
·
Adv Respir Med 2021;89(5):532-537.
Affiliations
  1. 1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
  2. Department of Radiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
  3. Department od Pathology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
  4. Department of Thoracic Surgery, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland

open access

Vol 89, No 5 (2021)
CASE REPORTS
Submitted: 2021-02-10
Accepted: 2021-03-30
Published online: 2021-07-16

Abstract

Actinomycosis is a rare disease caused by Actinomyces spp. The clinical and radiological picture of the disease is uncharacter-istic, which delays the diagnosis and can lead to complications. We present a case of pulmonary actinomycosis complicated by a chest wall fistula in a 43-year-old man with advanced tooth decay. The patient was admitted to our Department due to a chest wall fistula with bloody discharge. A few months earlier, he was treated with antibiotics for pneumonia. Since then, weakness, exertional dyspnoea, and weight loss had been observed. On admission, increased inflammatory markers were found in laboratory tests. Chest computed tomography (CT) revealed right-sided encapsulated pleural fluid collection containing gas bubbles, pleural thickening, anterior thoracic wall soft tissues thickening and subcutaneous fat stranding. CT suggested an empyema or a breast either pleural malignancy. The picture suggested a breast or pleural tumour to differentiate with an empyema. Videothoracoscopy was performed, the histological examination of the collected samples revealed granulation tissue and bacterial colony of a morphology corresponding to Actinomyces spp. Pulmonary actinomycosis was diagnosed. Antibiotic therapy according to the guidelines was initiated and dental treatment was recommended. Healing of the fistula and significant regression of lesions in the right lung were achieved. Although it is a rare disease, actinomycosis should be considered in the differential diagnosis of any chronic infiltrative lung lesions.

Abstract

Actinomycosis is a rare disease caused by Actinomyces spp. The clinical and radiological picture of the disease is uncharacter-istic, which delays the diagnosis and can lead to complications. We present a case of pulmonary actinomycosis complicated by a chest wall fistula in a 43-year-old man with advanced tooth decay. The patient was admitted to our Department due to a chest wall fistula with bloody discharge. A few months earlier, he was treated with antibiotics for pneumonia. Since then, weakness, exertional dyspnoea, and weight loss had been observed. On admission, increased inflammatory markers were found in laboratory tests. Chest computed tomography (CT) revealed right-sided encapsulated pleural fluid collection containing gas bubbles, pleural thickening, anterior thoracic wall soft tissues thickening and subcutaneous fat stranding. CT suggested an empyema or a breast either pleural malignancy. The picture suggested a breast or pleural tumour to differentiate with an empyema. Videothoracoscopy was performed, the histological examination of the collected samples revealed granulation tissue and bacterial colony of a morphology corresponding to Actinomyces spp. Pulmonary actinomycosis was diagnosed. Antibiotic therapy according to the guidelines was initiated and dental treatment was recommended. Healing of the fistula and significant regression of lesions in the right lung were achieved. Although it is a rare disease, actinomycosis should be considered in the differential diagnosis of any chronic infiltrative lung lesions.

Get Citation

Keywords

actinomycosis; tooth decay; fistula of chest wall; antibiotics

About this article
Title

Pulmonary actinomycosis complicated by fistula of the chest wall

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 5 (2021)

Article type

Research paper

Pages

532-537

Published online

2021-07-16

DOI

10.5603/ARM.a2021.0071

Pubmed

34269403

Bibliographic record

Adv Respir Med 2021;89(5):532-537.

Keywords

actinomycosis
tooth decay
fistula of chest wall
antibiotics

Authors

Ewa Łyżwa
Izabela Siemion-Szcześniak
Małgorzata Sobiecka
Aneta Kacprzak
Agnieszka Winiarska
Małgorzata Szołkowska
Krzysztof Karuś
Witold Tomkowski

References (13)
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