1
|
Boot M, Archer J, Ali I. The diagnosis and management of pulmonary actinomycosis. J Infect Public Health 2023; 16:490-500. [PMID: 36801629 DOI: 10.1016/j.jiph.2023.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/15/2022] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
Pulmonary actinomycosis is a rare infection caused by the bacterial species actinomyces. This paper aims to provide a comprehensive review of pulmonary actinomycosis to improve awareness and knowledge. The literature was analysed using databases including Pubmed, Medline and Embase from 1974 to 2021. After inclusion and exclusion, a total of 142 papers were reviewed. Pulmonary actinomycosis is a rare disease occurring in approximately 1 per 3,000,000 people annually. Historically, pulmonary actinomycosis was a common infection with high mortality; however, the infection has become rarer since the widespread use of penicillins. Actinomycosis is known as "the great masquerade"; however, it can be differentiated from other diseases with acid-fast negative ray-like bacilli and sulphur granules being pathognomonic. Complications of the infection include empyema, endocarditis, pericarditis, pericardial effusion, and sepsis. The mainstay of treatment is prolonged antibiotic therapy, with adjuvant surgery in severe cases. Future research should focus on multiple areas, including the potential risk secondary to immunosuppression from newer immunotherapies, the utility of newer diagnostic techniques and ongoing surveillance post-therapy.
Collapse
Affiliation(s)
| | - Jack Archer
- Wagga Base Hospital, NSW, Australia; Wagga Rural Clinical School, University of New South Wales, Australia.
| | - Ishad Ali
- Bowral Hospital, NSW, Australia; Bowral Rural Clinical School, University of Wollongong, Australia
| |
Collapse
|
2
|
Ayyanar P, Mohapatra PR, Sethy M. A rare diagnosis of pulmonary actinomycosis by bronchoalveolar lavage cytology. Cytopathology 2023; 34:158-160. [PMID: 36458469 DOI: 10.1111/cyt.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/09/2022] [Accepted: 11/23/2022] [Indexed: 12/04/2022]
Abstract
The role of a bronchoalveolar lavage sample cell block in the diagnosis of pulmonary actinomycosis.
Collapse
Affiliation(s)
- Pavithra Ayyanar
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Prasanta R Mohapatra
- Department of Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Madhusmita Sethy
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| |
Collapse
|
3
|
Ding X, Sun G, Fei G, Zhou X, Zhou L, Wang R. Pulmonary actinomycosis diagnosed by transbronchoscopic lung biopsy: A case report and literature review. Exp Ther Med 2018; 16:2554-2558. [PMID: 30186488 PMCID: PMC6122505 DOI: 10.3892/etm.2018.6483] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/02/2018] [Indexed: 11/05/2022] Open
Abstract
Pulmonary actinomycosis is a chronic, suppurative, granulomatous disease caused by Actinomyces israelii, an obligate anaerobe. The clinical manifestations and imaging characteristics of pulmonary actinomycosis lack specificity and can lead to confusion with tuberculosis and lung cancer. The present study reported a case of pulmonary actinomycosis diagnosed by transbronchoscopic lung biopsy and reviewed the literature on the disease. The clinical characteristics, signs, laboratory findings as well as progression, diagnosis and treatment in the case of pulmonary actinomycosis were analyzed. The patient was diagnosed by transbronchoscopic lung biopsy. After two weeks of antibiotic therapy, the cough was significantly improved and the patient's temperature returned to normal. Moreover, the lesion in the left lower lung was significantly smaller. Pulmonary actinomycosis is usually confused for tuberculosis and lung cancer. The present findings indicated that transbronchoscopic lung biopsy is a useful tool for diagnosing the disease. To conclude, doctors should have a clear enough understanding of the disease to prescribe empirical antibiotics and avoid unnecessary surgery.
Collapse
Affiliation(s)
- Xing Ding
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Gengyun Sun
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Guanghe Fei
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Xuexin Zhou
- The First Clinical College of Anhui Medical University, Hefei, Anhui 230001, P.R. China
| | - Luqian Zhou
- The First Clinical College of Anhui Medical University, Hefei, Anhui 230001, P.R. China
| | - Ran Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| |
Collapse
|
4
|
Tabarsi P, Yousefi S, Jabbehdari S, Marjani M, Baghaei P. Pulmonary Actinomycosis in a Patient with AIDS/HCV. J Clin Diagn Res 2017; 11:OD15-OD17. [PMID: 28764230 DOI: 10.7860/jcdr/2017/27593.10092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/11/2017] [Indexed: 11/24/2022]
Abstract
Pulmonary actinomycosis is a rare bacterial lung infection which is caused mainly by Actinomyces israelii. This non contagious infection can destroy parts of the lungs. There are variable presentations of pulmonary actinomycosis with similarity in manifestations to other infectious diseases of the lungs. Pulmonary actinomycosis is diagnosed by fine needle aspiration, bronchoscopy and finding of typical sulfur granules. We present a case of pulmonary actinomycosis in a middle aged (AIDS/HCV) man with massive hemoptysis and progressive dyspnoea. The bronchoscopy findings showed endobronchial mass with luminal occlusion in right upper lobe. Because of massive hemoptysis and poor response to conservative treatment and penicillin therapy, right upper lobectomy was needed to stop the bleeding. Histopathologic examination revealed the aggregations of filamentous Gram-positive organisms with characteristic pattern "sulfur granules", indicating actinomycosis. The patient was followed by six months of oral amoxicillin and has no recurrent hemoptysis.
Collapse
Affiliation(s)
- Payam Tabarsi
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis, Tehran, Iran
| | - Sootiya Yousefi
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayena Jabbehdari
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Marjani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis, Tehran, Iran
| | - Parvaneh Baghaei
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis, Tehran, Iran
| |
Collapse
|
5
|
An SH, Yi MJ, Yu R, Kim JH, Baek HS, Ban JE, Lim KJ, Yang S, Hwang IT, Kim SY. Tracheal Bronchus with Persistent Pulmonary Hypertension of the Newborn: A Case Report. NEONATAL MEDICINE 2017. [DOI: 10.5385/nm.2017.24.4.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Se Hwan An
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Min Ju Yi
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Rita Yu
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Ji-Hye Kim
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Hey-Sung Baek
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Ji-Eun Ban
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyoung Ja Lim
- Department of Radiology, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Seung Yang
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Il-Tae Hwang
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Su Yeong Kim
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea
| |
Collapse
|
6
|
Sharma S, Dey P, Poddar R. Pulmonary actinomycosis: a rare case diagnosed on bronchoalveolar lavage cytology. Cytopathology 2016; 28:436-437. [PMID: 28028884 DOI: 10.1111/cyt.12406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S Sharma
- Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Dey
- Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Poddar
- Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
7
|
Sander R, Fournier A, Mairal P, Borderias L. [Pneumonia and empyema due to Actinomyces meyeri: case report of an 80 year-old patient and a literature review]. Rev Esp Geriatr Gerontol 2016; 51:123-125. [PMID: 26253035 DOI: 10.1016/j.regg.2015.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/15/2015] [Accepted: 06/22/2015] [Indexed: 06/04/2023]
Affiliation(s)
- Rolf Sander
- Servicio Geriatría, Hospital Sagrado Corazón de Jesús, Huesca, España.
| | - Alejandro Fournier
- Medicina Familiar y Comunitaria, Hospital General San Jorge, Huesca, España
| | - Pilar Mairal
- Servicio de Microbiología, Hospital General San Jorge, Huesca, España
| | - Luis Borderias
- Servicio de Neumología, Hospital General San Jorge, Huesca, España
| |
Collapse
|
8
|
Abstract
Actinomyces israelii has long been recognized as a causative agent of actinomycosis. During the past 3 decades, a large number of novel Actinomyces species have been described. Their detection and identification in clinical microbiology laboratories and recognition as pathogens in clinical settings can be challenging. With the introduction of advanced molecular methods, knowledge about their clinical relevance is gradually increasing, and the spectrum of diseases associated with Actinomyces and Actinomyces-like organisms is widening accordingly; for example, Actinomyces meyeri, Actinomyces neuii, and Actinomyces turicensis as well as Actinotignum (formerly Actinobaculum) schaalii are emerging as important causes of specific infections at various body sites. In the present review, we have gathered this information to provide a comprehensive and microbiologically consistent overview of the significance of Actinomyces and some closely related taxa in human infections.
Collapse
|
9
|
Branquinho DF, Andrade DR, Almeida N, Sofia C. Mediastinitis by Actinomyces meyeri after oesophageal stent placement. BMJ Case Rep 2014; 2014:bcr-2014-204499. [PMID: 24903727 DOI: 10.1136/bcr-2014-204499] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Actinomyces meyeri is a Gram-positive anaerobic forming bacterium of the genus Actinomyces, part of the oral cavity's flora, and its classification remains an unresolved issue. It is an extremely rare cause of disease, occurring in middle-aged immunocompetent patients and frequently misdiagnosed as malignancy or lung abscess. A 56-year-old man diagnosed with oesophageal squamous cell carcinoma had an endoscopically placed stent to palliate his dysphagia. Two weeks later he presented with thoracalgia and fever, interpreted as a common lung infection. Owing to lack of improvement, additional examinations were undertaken revealing mediastinum involvement. Unlike the good prognosis usually associated with this infection, the patient eventually died, reflecting the aggressive nature of his underlying condition. To our knowledge, this is the first report of mediastinitis by A. meyeri, supporting the described propensity of this agent to disseminate, particularly to the thoracic cavity, although probably in this case with an iatrogenic contribution.
Collapse
Affiliation(s)
| | | | - Nuno Almeida
- Department of Gastroenterology, Coimbra University Hospital, Coimbra, Portugal
| | - Carlos Sofia
- Department of Gastroenterology, Coimbra University Hospital, Coimbra, Portugal
| |
Collapse
|
10
|
The "forgotten zone": acquired disorders of the trachea in adults. Respir Med 2013; 107:1301-13. [PMID: 23669413 PMCID: PMC7125950 DOI: 10.1016/j.rmed.2013.03.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 03/14/2013] [Accepted: 03/26/2013] [Indexed: 12/22/2022]
Abstract
The upper airway is generally defined as the air passage segment that extends between the naso- or oropharynx and the carina. The longest segment of the upper airway—the trachea—begins at the inferior portion of the larynx and extends to the branch point of the main carina. The trachea has the potential to be a “forgotten zone” in differential diagnoses, as pathological processes involving this portion may not receive prominent clinical consideration in disorders presenting with respiratory symptoms and signs. Unlike the oropharynx, this anatomical area is beyond visualization on routine inspection; unlike the mediastinum and lung fields, it is a potential “blind spot” on initial, plain radiographic examination of the chest. Nonetheless, the adult trachea is affected by a number of primary disorders and is also a target organ of a variety of systemic diseases. This review will focus on both primary and systemic diseases involving the adult trachea with specific attention to their clinical manifestations and diagnostic hallmarks.
Collapse
|
11
|
Tracheal bronchus associated with recurrent pneumonia. THE ULSTER MEDICAL JOURNAL 2013; 82:94-6. [PMID: 24082287 PMCID: PMC3756866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/30/2013] [Indexed: 11/03/2022]
Abstract
Abnormalities of the major airways are very uncommon congenital conditions which occur in approximately 2% of the adult population. Usually aberrant bronchi are asymptomatic and are only found by coincidence. We present the rare case of a 49-years-old woman with a tracheal bronchus causing associated with recurrent pneumonia of the right upper lobe.
Collapse
|
12
|
Fazili T, Blair D, Riddell S, Kiska D, Nagra S. Actinomyces meyeri infection: case report and review of the literature. J Infect 2012; 65:357-61. [PMID: 22406688 DOI: 10.1016/j.jinf.2012.02.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 02/16/2012] [Accepted: 02/27/2012] [Indexed: 11/19/2022]
Abstract
Actinomyces meyeri is an uncommon cause of actinomycosis. We present a patient with pneumonia and empyema due to A. meyeri. The patient underwent open thoracotomy with decortication and was discharged home on a twelve-month course of oral penicillin. Review of the English literature revealed thirty-two cases of infection due to A. meyeri. The majority of patients were male, and a significant number had poor dental hygiene and a history of alcoholism. More than other Actinomyces species, A. meyeri causes pulmonary infection and has a predilection for dissemination. Prognosis is favorable with prolonged penicillin therapy combined with surgical debridement, if needed.
Collapse
Affiliation(s)
- Tasaduq Fazili
- Department of Medicine, Division of Infectious Diseases, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
| | | | | | | | | |
Collapse
|