ABSTRACT
Actinomycosis is an indolent, slowly progressive infection caused by anaerobic bacteria, primarily of the genus Actinomyces, that colonize the mouth, colon, and vagina. A vital step in the development of actinomycosis is disruption of the mucosal barrier. Actinomycosis occurs most frequently at a cervicofacial, abdominal, and pelvic region. Thoracic actinomycosis usually follows an indolent progressive course with involvement of the pulmonary parenchyma and/or the pleural space. Rarely, pulmonary nodules or endobronchial lesions can occur. We report a case of a 62-year-old woman of chronic cough with sputum and pulmonary mass with consolidation at the right lower lobe on chest radiography. Fiberoptic bronchoscopic findings revealed a polypoid tumor like mass completely obstructing RLL lobar bronchus and a hard bony material embedded there. Histologic examination of the biopsy specimens demonstrated acute and chronic inflammation with calcified material and a sulfur granule, which led to the diagnosis of endobronchial actinomycosis. The patient responded to several bronchoscopic procedures and intravenous penicillin G.
Subject(s)
Female , Humans , Middle Aged , Actinomyces , Actinomycosis , Bacteria, Anaerobic , Biopsy , Bronchi , Bronchoscopy , Colon , Cough , Diagnosis , Foreign Bodies , Inflammation , Mouth , Pelvis , Penicillin G , Radiography , Sputum , Sulfur , Thorax , VaginaABSTRACT
Actinomycosis is an indolent, slowly progressive infection caused by anaerobic bacteria, primarily of the genus Actinomyces, that colonize the mouth, colon, and vagina. A vital step in the development of actinomycosis is disruption of the mucosal barrier. Actinomycosis occurs most frequently at a cervicofacial, abdominal, and pelvic region. Thoracic actinomycosis usually follows an indolent progressive course with involvement of the pulmonary parenchyma and/or the pleural space. Rarely, pulmonary nodules or endobronchial lesions can occur. We report a case of a 62-year-old woman of chronic cough with sputum and pulmonary mass with consolidation at the right lower lobe on chest radiography. Fiberoptic bronchoscopic findings revealed a polypoid tumor like mass completely obstructing RLL lobar bronchus and a hard bony material embedded there. Histologic examination of the biopsy specimens demonstrated acute and chronic inflammation with calcified material and a sulfur granule, which led to the diagnosis of endobronchial actinomycosis. The patient responded to several bronchoscopic procedures and intravenous penicillin G.