Pulmonary Actinomycosis Masquerading as a Malignant Lung Tumor in a 9-Year-Old Boy

Actinomicose torácica simulando doença neoplásica em Pediatria

“…Rib involvement is frequent, although sternum or vertebra invasion is rare (2,4) . Lower pulmonary lobes are the most affected (9) .…”

“…Microorganisms of the Actinomyces genus are uniformly sensitive to penicillin, and the treatment is generally a combination of prolonged antibiotic therapy with surgical drainage. Despite the absence of available data to justify the optimal duration of treatment, most authors recommend that antibiotic treatment should last between six and 12 months, being administered intravenously at the beginning and then orally (2,3,(8)(9)(10)(11) . The evolution is satisfactory, rarely leading to death in children (2,12) .…”

Pulmonary actinomycosis with remote lower chest wall involvement in an immunocompetent child

“…Pulmonary actinomycosis constitutes approximately 15% of actinomycosis cases and is usually caused by either the inhalation of contaminated aerosol particles or extension from an existing colonization of the oropharygeal cavity 2 . Predisposing factors usually include poor dental hygiene or dental caries, underlying respiratory disorders, periodontal disease, paranasal sinusitis, immunocompromised status, and mentally subnormal status in children 1,4–7 . The hematogenous route had been postulated in some rare situations 8 …”

“…Surgical intervention is indicated only in some situations, such as empyema, hemoptysis, abscess formation, discharging fistulas, and sinuses 12 . To differentiate malignancy from other infectious diseases, however, surgical intervention is usually necessary even without these indications 4–7,12 …”

“…There have been a few reports on children with primary pulmonary actinomycosis in recent 10 years, 3–5 but coincident remote lower chest wall involvement has never been reported. We report here a 10‐year‐old immunocompetent girl presenting with chest pain and pulmonary infiltrate, who was found to have pulmonary actinomycosis with remote chest wall involvement.…”