ABSTRACT
Chest wall tuberculosis is a rare form of tuberculosis. Its presentations often misguide the clinician and produce a diagnostic dilemma. High index of suspicion should be exercised. A case of chest wall tuberculosis in a 90-year old male is reported that was managed with variety of diagnosis. Careful approach to a patient of chest wall nodules without any other signs and symptoms of tuberculosis may clinch early diagnosis
Subject(s)
Humans , Male , Thoracic Wall/microbiologyABSTRACT
No abstract available.
Subject(s)
Aged , Humans , Male , Abscess/diagnosis , Anti-Bacterial Agents/therapeutic use , Biopsy, Needle/adverse effects , Drainage , Gram-Positive Bacterial Infections/diagnosis , Image-Guided Biopsy/adverse effects , Lung/pathology , Peptostreptococcus/isolation & purification , Thoracic Wall/microbiology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Actinomycosis is an infrequent infection caused by bacteria from Actinomyces genus that manifests as a chronic, suppurative and progressive disease. It's more common in men. Thoracic actinomycosis occurs in 15% of the cases, and infection of the chest wall is less frequent. The clinical presentation mimics tuberculosis or neoplastic processes. In this article we present the case of a 63 year-old man with no comorbidity, with pulmonary actinomycosis involving the chest wall mimicking a neoplastic process, basing the diagnosis on histopathologic findings.
La actinomicosis es una infección poco común causada por bacterias del género Actinomyces que se manifiesta como una enfermedad crónica, supurativa y progresiva. Es más frecuente en hombres. La actinomicosis torácica se presenta en 15% de los casos, siendo el compromiso de pared torácica aún menos frecuente. La presentación clínica simula procesos neoplásicos o tuberculosis. Se describe el caso de un hombre de 63 años, sin co-morbilidad, con una actinomicosis pulmonar con compromiso de pared torácica que simuló ser un proceso neoplásico. El diagnóstico fue confirmado por los hallazgos histopatológicos.
Subject(s)
Humans , Male , Middle Aged , Actinomycosis/diagnosis , Lung Neoplasms/diagnosis , Respiratory Tract Infections/diagnosis , Actinomycosis/microbiology , Diagnosis, Differential , Lung/microbiology , Respiratory Tract Infections/microbiology , Thoracic Wall/microbiologyABSTRACT
Actinomycosis is a rare, chronic, suppurative, granulomatous infection caused by a group of gram-positive anaerobic bacteria belonging to the natural flora of the oral cavity and gastrointestinal and urogenital tracts. It may involve several organs. This case study refers to pulmonary actinomycosis with chest wall involvement and cord compression in a 29-year-old male who presented with fever, cough, hemoptysis, neck pain, and paresis and plegia of the lower limbs of 5-month duration.
A actinomicose é uma infecção rara, crônica, supurativa e granulomatosa, causada por um grupo de bactérias anaeróbias Gram-positivas que pertencem à flora natural da cavidade oral, do aparelho gastrointestinal e urogenital. Pode envolver diversos órgãos. O estudo refere-se à actinomicose pulmonar com envolvimento da parede torácica e compressão medular em um paciente masculino com 29 anos que apresentava febre, tosse, hemoptise e cervicalgia, além de paresia e plegia em membros inferiores com cinco meses de evolução.
Subject(s)
Adult , Humans , Male , Actinomycosis/complications , Lung Diseases/complications , Spinal Cord Compression/microbiology , Thoracic Wall/microbiology , Actinomycosis/diagnosis , Decompression, Surgical , Lung Diseases/microbiology , Magnetic Resonance Imaging , Spinal Cord Compression/diagnosis , Spinal Cord Compression/surgery , Tomography, X-Ray ComputedABSTRACT
A actinomicose é uma infecção rara que pode envolver diversos órgãos. O envolvimento torácico é incomum (10-20 por cento). No presente trabalho, é descrito o caso de um paciente de 33 anos, HIV negativo, com dor torácica posterior à esquerda em queimação com irradiação para membro superior esquerdo e diminuição da força com parestesias. A tomografia computadorizada evidenciou uma massa em contato com a parede torácica. Após realização de toracotomia foi visualizada lesão pulmonar sólida vascularizada aderida no lobo superior esquerdo, infiltrando a parede torácica posterior e ápice da cavidade. A biopsia incisional da lesão e o estudo microbiológico evidenciaram actinomicose.
Actinomycosis is a rare infection that may involve several organs. Thoracic involvement is uncommon (10-20 percent). This article describes the case of a 33 year-old patient, HIV negative, complaining of burning pain in the left posterior chest radiating to the left upper arm and reduced strength and paresthesias. The CT scan showed a mass in close contact with the chest wall. Following a thoracotomy, observation verified a solid pulmonary lesion adhered to the left upper lobe, infiltrating the posterior thoracic wall and apex of the cavity with rich vascularization. An incisional biopsy of the lesion and microbiological study revealed actinomycosis.
Subject(s)
Adult , Humans , Male , Actinomycosis/diagnosis , Lung Diseases, Fungal/diagnosis , Pancoast Syndrome/diagnosis , Diagnosis, Differential , Tomography, X-Ray Computed , Thoracic Wall/microbiologyABSTRACT
A Actinomicose é uma infecção rara, crônica, supurativa e granulomatosa que pode envolver diversos órgãos. A infecção pulmonar geralmente está relacionada à imunodepressão e à saúde bucal precária. O envolvimento torácico é incomum (10 - 20 por cento), a parede torácica é acometida em apenas 12 por cento destes casos. No presente trabalho, é descrito o caso de um paciente de 26 anos, não HIV e sem co-morbidades, assintomático respiratório, com massa infra-escapular, de crescimento progressivo, muito dolorosa, com sinais locais flogísticos, sem trauma local, apresentando febre persistente, com três meses de evolução. O diagnóstico inicial foi de neoplasia de partes moles de parede torácica. A biopsia incisional da referida massa, houve saída de secreção gelatinosa vinhosa com grânulos amarelados, sugestivos de actinomicose, sendo confirmado por exame anatomopatológico. Empiricamente foi instituída ciprofloxacina devido alergia à cefalosporina. Houve excelente resposta clínica à drenagem externa e à medicação prescrita. Não houve recaída da doença em 18 meses de seguimento.
Actinomycosis is an uncommon suppurative granulomatous chronic infection that may involve several organs. Lung infection is usually related to immunodepression and poor oral hygiene. Cases of thoracic involvement are rare (10 - 20 percent) and only 12 percent of such cases affect the chest wall. This report describes the case of a 26-year-old HIV-negative patient without comorbidities or respiratory complaints who presented a very painful, progressively growing infrascapular mass, with local phlogistic signs and no local trauma, and persistent fever. It had been progressing for three months. The initial diagnosis was neoplasia of chest wall soft tissue. However, incision biopsy in this mass produced a red wine-colored gelatinous secretion containing yellowish granules suggestive of actinomycosis, which was later confirmed by anatomopathological examination. Ciprofloxacin was instituted empirically because of cephalosporin allergy. There was an excellent clinical response to external drainage and the prescribed medication. Over the course of 18 months of follow-up, there was no disease recurrence.