Surgical considerations for pulmonary actinomycosis

Endo, Shunsuke; Murayama, Fumio; Yamaguchi, Tsutomu; Yamamoto, Shinichi; Otani, Shinichi; Saito, Noriko; Sohara, Yasunori

doi:10.1016/s0003-4975(02)03616-0

Cited by 39 publications

(43 citation statements)

References 16 publications

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“…The average duration of treatment is 4 to 5 months (8). Diagnosis or treatment of pulmonary actinomycosis usually requires surgical intervention (9). Although surgery seems to be the best treatment modality (10), less invasive techniques, like embolization of the related artery in selected cases with hemorrhage, might be favorable due to fewer complications.…”

Section: Discussionmentioning

confidence: 99%

A Rare Cause of Massive Pulmonary Hemorrhage: Invasive Actinomycosis

Kara¹,

İnecikli²,

Memoğlu³

et al. 2018

Respir Case Rep

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Pulmonary actinomycosis is a severe clinical condition that may cause death if unrecognized. It may occur in patients who were previously healthy or may develop in patients with chronic immunosuppressant conditions. Presently described is a rare case of massive pulmonary hemorrhage with a related angioinvasive Actinomyces infection. A 52-year-old formerly immunocompetent man was admitted to the hospital due to blood-streaked sputum. A computed tomography image of the thorax taken after the patient's clinical status suddenly worsened revealed total collapse of the left lung. No tumoral lesion was observed, but extensive necrosis of the mucosa of both main bronchi with massive hemorrhage in the left main bronchus was noticed in an urgent bronchoscopy performed in the intensive care unit. A histopathological examination of the mucosal punch biopsy demonstrated aggregates of filamentous Grampositive organisms indicating Actinomyces infection. ÖzetPulmoner aktinomikoz geç tanı konulduğunda ölümle sonuçlanabilecek bir durumdur. Daha çok immün yetmezliği olan bireylerde beklendiği gibi immün-kompetan kişilerde de görülebileceği unutulmamalı-dır. Bu yazıda invaziv pulmoner aktinomikoza bağlı masif pulmoner hemoraji gelişen nadir bir olgu sunulmuştur. Elli iki yaşında bilinen immünsupresif durumu olmayan erkek hasta ağızdan balgamla karışık kan gelmesi nedeni ile yatırıldı. Elektif bronkoskopi planlanan hastanın genel durumunda ani kötüleşme nedeni ile çekilen toraks bilgisayarlı tomografisinde sol akciğerde başvuruda olmayan total atelektazi saptandı. Yoğun bakım ünitesinde yapılan acil bronkoskopide sol ana broşta masif hemoraji ve her iki ana bronş mukozasında yaygın nekrotik görünüm izlendi. Alınan mukozal biyopsinin patolojik incelemesinde aktinomikozla uyumlu gram pozitif filamentöz bakteri agregatları izlendi. Bronşiyal arter kateterizasyonunda ekstravazasyon saptanan artere

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Section: Discussionmentioning

confidence: 99%

A Rare Cause of Massive Pulmonary Hemorrhage: Invasive Actinomycosis

Kara¹,

İnecikli²,

Memoğlu³

et al. 2018

Respir Case Rep

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“…La infección torácica es consecuencia de la aspiración de microorganismos propios de la boca y orofaringe en pacientes entre la quinta y sexta década de vida, con factores predisponentes como una pobre higiene oral 15 . Probablemente, el mayor número de casos en este grupo etario se debe a una mayor incidencia de co-morbilidades como: diabetes mellitus, tabaquismo, alcoholismo, neoplasias, enfermedades pulmonares crónicas, inmunosupresión, deterioro en la dentadura y enfermedad periodontal [16][17][18] . De manera común, la infección se origina en el parénquima pulmonar y puede progresar a la pared torácica directamente extendiéndose a través de la pleura 14 .…”

Section: Discussionunclassified

Actinomicosis torácica como diagnóstico diferencial de neoplasia: a propósito de un caso

Pereira

Cuevas

Valencia

et al. 2012

Rev. chil. infectol.

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“…When it is pathogenic, it cause a characteristic granulomatous inflammatory reaction, followed by necrosis and extensive fibrotic reaction. It mainly presents in three forms: cervicofacial (50%), abdominal (20%) and thoracic (15%) [6,7,14,15]. The involvement of the gynecological tract has been recently reported, related to the use of an intrauterine device [6,14].…”

Section: Discussionmentioning

confidence: 99%