Surgery in thoracic actinomycosis

Boudaya, Mohamed Sadok; Smadhi, H.; Marghli, A.; Mlika, Mouna; Charmiti, Fatma; Ismail, Olfa; Kilani, T.

doi:10.1177/0218492312439310

Cited by 11 publications

(10 citation statements)

References 14 publications

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“…Choi et al [10] reported a 100% cure rate in 26 cases without recurrence, despite a relatively short follow-up duration (median 23 months). Possible explanations for treatment failure are drug-resistant co-pathogens and poor penetration of the drug caused by avascularity and induration of the infected area [14]. Although reported antimicrobial susceptibility tests indicate that most Actinomyces are susceptible to penicillin and amoxicillin, Actinomyces may acquire antibiotic resistance during antibiotic treatment [15,16].…”

Section: Discussionmentioning

confidence: 99%

Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis

Park

Lee

et al. 2014

BMC Infect Dis

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BackgroundThere have been few studies of pulmonary actinomycosis, which is an uncommon anaerobic infection. Consequently, the optimal therapeutic regimen, appropriate duration of treatment, long-term prognosis, and factors predicting prognosis are not well established.MethodsWe retrospectively reviewed the medical records of histopathologically confirmed cases of pulmonary actinomycosis seen between November 2003 and December 2012.ResultsThe study included 68 patients with a mean age of 58.4 ± 11.6 years. Of the 68, initial surgery was performed in 15 patients (22.1%), while the remaining 53 (77.9%) received antibiotic therapy initially. In the initial antibiotic group, 45/53 (84.9%) were cured without relapse (median antibiotic duration 5.3 months). 5/53 (9.4%) patients were refractory medically (median antibiotic duration 9.7 months), and 3/53 (5.7%) experienced a recurrence (median time to relapse 35.3 months). In the initial surgery group, 14/15 (93.3%) were cured and treatment failure occurred in one (6.7%). In the multivariate analysis, the absence of an antibiotic response at 1 month was the only independent factor associated with a poor treatment outcome, with an adjusted odds ratio of 49.2 (95% CI, 3.34–724.30). There was no significant difference in treatment outcome based on the size of the parenchymal lesion, comorbidities, whether intravenous antibiotics were used, antibiotic therapy duration, or whether the initial treatment was surgical.ConclusionsAntibiotic treatment with or without surgery was effective for treatment of pulmonary actinomycosis. Nevertheless, treatment failure or recurrence occurred in a considerable proportion of patients, especially those resistant to the initial antibiotic treatment.

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Section: Discussionmentioning

confidence: 99%

Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis

Park

Lee

et al. 2014

BMC Infect Dis

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“…Transbronchial or open lung biopsies are often in order to make the diagnosis. With the propensity of actinomycosis to mimic malignancy, diagnosis is often made after surgical resection [3]. …”

Section: Discussionmentioning

confidence: 99%

“…Relapse is common, but with treatment, long-term prognosis is good. The combination of surgery plus antibiotics has been shown in small trials to prevent relapse [3, 4]. …”

Section: Discussionmentioning

confidence: 99%

A 75-Year-Old Female with Hemoptysis and Recurrent Respiratory Infections

Baker

Diab

2013

Case Reports in Critical Care

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This paper describes the case of a 75-year-old female who presented with significant hemoptysis over a 7–10 day period. She had a history of a left lower lobectomy 10 years prior for a “lung abscess.” She subsequently had multiple episodes of cough, fevers, and possible pneumonia treated with multiple courses of Amoxicillin and Amoxicillin/Clavulanate. Review of her chest CT upon presentation to the hospital showed a large necrotic lingular infiltrate, which had been progressively increasing in size over at least one year. Bronchoscopy showed a yellowish, soft round body in the superior lingular subsegment. Endobronchial and transbronchial biopsies showed actinomyces species. This is a very interesting case of indolent actinomycosis which we suspect had a very slow progressive course secondary to the multiple courses of antibiotics that the patient was treated with.

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“…Także badania inwazyjne, jak biopsja bronchoskopowa, przezoskrzelowa biopsja płuca czy przezskórna biopsja cienkoigłowa lub gruboigłowa mają małą czułość, nawet mimo powtarzania. Stąd w zdecydowanej większości przypadków rozpoznanie promienicy, podobnie jak u tego chorego, jest rozpoznaniem histologicznym z pobranego wycinka drogą chirurgicznej biopsji płuca i przez niektórych autorów uznawane jest za "złoty standard" diagnostyczny [11,12].…”

Section: Dyskusjaunclassified

Rzadka Manifestacja Płucna Promienicy w Postaci Zmian Rozsianych

Nowicka

Modrzewska

Pasik³

et al. 2013

Advances in Respiratory Medicine

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Promienica to rzadko występująca, przewlekła choroba infekcyjna wywołana przez bakterie beztlenowe Gram-dodatnie z rodzaju Actinomyces. Indukują one odczyn zapalny o charakterze ropnym w tkankach. Promieniowce są komensalami bytującymi w jamie ustnej, przewodzie pokarmowym i drogach rodnych, a infekcje mają charakter niemal wyłącznie endogenny. Ze względu na zmienny obraz kliniczny, przewlekły przebieg, częściej przypomina chorobę nowotworową niż zakaźną. Przedstawiamy przypadek 56-letniego mężczyzny z niezwykle rzadką płucną manifestacją promienicy w postaci obustronnych rozsianych guzków w miąższu płuc z objawami ogólnymi, po wstępnym leczeniu przeciwprątkowym. Rozpoznanie ostatecznie ustalono na podstawie badania histologicznego wycinków z płuc. Po 7 miesiącach leczenia przeciwbakteryjnego uzyskano poprawę kliniczną i radiologiczną.

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Surgery in thoracic actinomycosis

Abstract: Diagnosis of actinomycosis can be problematic because of difficulty in isolating actinomyces. In these cases, surgery is very helpful.

Cited by 11 publications

References 14 publications

Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis

Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis

A 75-Year-Old Female with Hemoptysis and Recurrent Respiratory Infections

Rzadka Manifestacja Płucna Promienicy w Postaci Zmian Rozsianych

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