Two cases of endobronchial actinomycosis that were cured by bronchoscopic removal and short-term antibiotic therapy / 대한내과학회지

Actinomycosis is an uncommon, chronic granulomatous, suppurative disease related to Actinomyces israelii, which is a natural inhabitant of the oropharyngeal cavity and the major human pathogen of actinomycosis. In the past, dramatic presentation of thoracic actinomycosis, in conjunction with prominent chest pain and cutaneous fistulas that discharge sulfur granules, has frequently been reported. However, more recent data indicate that chest wall or rib involvement is now much less common than was previously encountered. This could result in more favorable responses to short-term intravenous antibiotic therapy. Foreign-body-associated actinomycosis is a very rare type of thoracic actinomycosis. We report two cases of endobronchial actinomycosis associated with a foreign body. In both cases, the foreign body was successfully removed by bronchoscopy. Each patient was treated with antibiotics for about 70 days. The duration of antibiotic therapy was relatively short, as compared to conventional therapy. Nevertheless, there was no recurrence or complications over 1 year.

Two Cases of Endobronchial Actinomycosis that were Cured by Operation and Short Term Antibiotics Therapy / 결핵및호흡기질환

Endobronchial actinomycosis is a rare chronic suppurative granulomatous infection of the bronchus, and this is sometimes related with a foreign body or a broncholith. The traditional treatment of endobroncial actinomycosis is intravenous antibiotics for 2 to 6 weeks and then oral antibiotics therapy for 6 to 12 months. We report here on 2 cases of endobronchial actinomycosis that were associated with a broncholith and a foreign body, respectively. Surgery followed by short term antibiotics therapy for only 20 days and 34 days, respectively, was effective as treatment for the endobronchial actinomycosis in our cases. After treatment, there were no complications or recurrence during the following period. We suggest that short term antibiotics therapy combined with a surgical operation might be effective as treatment for primary endobronchial actinomycosis, and especially when this illness is combined with a foreign body or a broncholith, as compared with traditional long term antibiotic therapy.

Primary Endobronchial Actinomycosis / 결핵

We report a case of a 20-year-old woman who presented with fever, dry cough and pulmonary consolidation at the left upper lobe on chest radiograph. Fiberoptic bronchoscopy revealed obstruction of the left upper lobar bronchus with exophytic mass and multiple nodular protruding lesions at the left main bronchus. Endobronchial actinomycosis was confirmed by demonstration of sulfur granule through the bronchoscopic biopsy of nodular lesion. Intravenous administration of penicillin G followed by oral tetracycline therapy for 5 months resulted in complete recovery of symptoms which had been present for 3 months prior to therapy. Infiltrative consolidation on the chest X-ray disappeared and all the lesions shown by bronchoscopy were nearly normalized after 6 months only to remain small nodular remnants at the left main bronchus. Endobronchial actinomycosis should be included in the differential diagnosis of endobronchial mass.