title: Bilateral pulmonary infiltrates in association with disseminated actinomycosis.
abstract: The most common infectious cause of bilateral upper-lobe pulmonary disease is tuberculosis. However, we recently encountered a patient with bilateral apical infiltrates and multiple soft-tissue abscesses caused by Actinomyces odontolyticus. Other findings included fever, weight loss, and leukocytosis, and the patient's only known source of immunosuppression was a long history of alcoholism. There was no history of diabetes, steroid use, or other chronic underlying disease. The diagnosis was made by culture of drainage fluid from one abscess. Therapy with intravenous penicillin G led to rapid clinical improvement and reduction in the infiltrates. To our knowledge, the presentation of pulmonary infection, with bilateral apical infiltrates due to A. odontolyticus has not been previously reported in the medical literature.
authors.affiliation: Department of Medicine, University of Florida College of Medicine, Gainesville 32610-0277.
authors.forename: F
authors.initials: F
authors.lastname: Dontfraid
authors.forename: R
authors.initials: R
authors.lastname: Ramphal
mesh_terms: D000190:Actinomyces / Q000187:drug effects / Q000302:isolation & purification*; D000196:Actinomycosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008169:Lung Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000627:therapeutic use; D011859:Radiography
chemical_list: D010400:Penicillin G