Pulmonary actinomycosis in Brazil: a retrospective case series

We present a retrospective case series of 09 subjects diagnosed with pulmonary actinomycosis between February 2007 and November 2017 on a Brazilian center. Data were collected from review of medical records, microbiological exams and computed tomography (CT).The majority of patients were men (66%) and middle-aged (median age 45 years). Almost a half (4/9 - 44%) had a history of pulmonary comorbidities (bronchiectasis, asthma, tuberculosis). The most common symptoms were cough (8/9 - 88%), sputum production (7/9 - 77%) and hemoptysis (5/9 - 55%). Consolidation was the most common chest CT finding (7/9 - 77%), followed by bronchiectasis and mediastinal lymph node enlargement (5/9 - 55%). C-reactive protein was elevated in almost all patients (mean 58,8 mg/L - reference range <5 mg/L). The organisms isolated were A. odontolyticus (three), A. viscosus (two) and Actinomyces sp. (five). Oral Amoxicilin was the first treatment option, with good clinical responses and resolution of CT images in almost all cases. Two patients were submitted to surgical resection due to treatment failure.Actinomycosis represents a rare disease that can mimic different respiratory conditions, such as tuberculosis, nocardiosis and lung cancer. A high clinical suspicion, with a correct microbiological analysis, is necessary for a correct diagnosis. Early treatment initiation brings an optimal clinical outcome on most cases.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Respiratory infections Source Type: research