Organizing Pneumonia due to Actinomycosis: An Undescribed Association

Abstract

Organizing pneumonia is a pathologic entity characterized by intra-alveolar buds of granulation tissue that can extend to the bronchiolar lumen. It is a non-specific finding reflecting a pattern of pulmonary response to aggression that can be cryptogenic or associated with several causes. Pulmonary actinomycosis is a rare infectious disease, of bacterial aetiology, and of difficult diagnosis. This disease usually causes non-specific respiratory symptoms and radiological findings, and the treatment is based on the use of antibiotics. The authors describe a clinical case of a 53-year-old male smoker (50 pack years), initially seen for complaints of right-sided chest pain and sub-febrile temperature. Imaging studies revealed a mass in the inferior right lobe and enlarged mediastinal lymph nodes. Empirical treatment with antibiotics caused partial and temporary improvement. Transthoracic biopsy revealed a pattern of organizing pneumonia with giant multinucleated cell granulomas. Repeat imaging studies revealed an enlargement of the pulmonary mass and therefore a right inferior lobectomy was performed. The pathologic study revealed a histological pattern of organizing pneumonia surrounding inflammatory bronchiectasis with a large number of Actinomyces colonies. To our knowledge there is presently no report in the literature of organizing pneumonia associated with Actinomyces infection.

Organizing Pneumonia Secondary to Pulmonary Actinomycosis: A Case Report and Literature Review

“…Our patient showed acute chronic worsening of his respiratory status; however, the patients in the two other reported cases manifested chronic respiratory and constitutional symptoms. Our patient and the patient in the report by Alfaro et al [13] had the aspiration of oropharyngeal contents as the major risk factor. Findings on chest imaging were variable in the three cases.…”

Gastroesophageal Reflux Disease Is a Risk Factor for Severity of Organizing Pneumonia

“…OP can have many causes: infection, radiation therapy, drugs, allogenic bone marrow graft or lung transplantation, inhalation of respiratory irritants as well as being secondary to systemic diseases (e.g. Sjögren's syndrome), hemopathy or solid tumors [1,6,7,8,9,10,11,12]. When no cause can be determined, it is called cryptogenic organizing pneumonia (COP) [8,13].…”

Rzadka Manifestacja Płucna Promienicy w Postaci Zmian Rozsianych

“…Częstość zakażeń znacznie zmniejszyła się w ciągu ostatnich 30-40 lat, prawdopodobnie wskutek poprawy higieny jamy ustnej, jak też i wrażliwości Actinomyces na najczęściej stosowane antybiotyki. Do zakażenia promieniowcem predysponuje nasilona próchnica zębów, ekstrakcje zębów, zapalenia dziąseł, urazy żuchwy, infekcje przy wyrzynaniu się zębów, aspiracje ciała obcego, zachłyśnięcia, a także choroby towarzyszące -przewlekła choroba układu oddechowego (przewlekłe zapalenie oskrzeli, rozedma, rozstrzenie oskrzeli) i alkoholizm [7]. Nie stwierdza się natomiast zwiększonej częstości zachorowań u pacjentów z zaburzeniami odporności, w tym zakażonych wirusem HIV [4].…”