[A case report of pulmonary actinomycosis and review of the literature].

OBJECTIVE

To improve the awareness of primary pulmonary actinomycosis.

METHODS

One case of primary endobronchial actinomycosis was reported and 187 cases of primary pulmonary actinomycosis reported in the literature were reviewed.

RESULTS

A 66-year-old female had had recurrent cough, sputum production and fever for 4 years. Chest X-ray showed pneumonia in the right middle lobe. The diagnosis of pulmonary actinomycosis was confirmed by histopathological examination. The incidence of bronchopulmonary actinomycosis was 2 times higher in males than in females. The common clinical presentations included cough, sputum and chest pain with a shadow or shadows on chest radiograph. The findings on CT included patchy air-space consolidation, multifocal nodular appearance, cavitation, pleural effusions or thickening and hilar and/or mediastinal lymphadenopathy. Accurate diagnosis was generally made by histopathological examination of transbronchoscopic biopsy or surgical samples. Penicillin, tetracycline, erythromycin, sulphanilamide, lincomycin and surgical resection remained to be the treatment of choice over the last 50 years.

CONCLUSIONS

Primary bronchopulmonary actinomycosis is a rare infectious disease. Early diagnosis and proper treatment can lead to good outcomes with a low mortality.