Thoracic actinomycosis with mainly pleural involvement.
A 61-year-old man, who had been diagnosed with pleuritis 5 months earlier, was admitted to our hospital to determine if a tumor shadow that appeared in his right lower lung field on March 2002 was a localized pleural mesothelioma. Although a CT-guided lung biopsy was performed, no definite diagnosis was made. However, because the tumor shadow continued to increase in size, we could not rule out the possibility of a malignant thoracic tumor, and performed video-assisted thoracoscopic surgery (VATS). Histological examination of the surgically resected tissue led to a diagnosis of thoracic actinomycosis in the main component of the pleura. Because the recurrence of pulmonary actinomycosis was also suspected after surgical treatment, penicillin G was administered intravenously and afterward amoxicillin was administered intraorally. Subsequently, the patient's clinical status improved. We considered a case of thoracic actinomycosis that was suspected to have spread directly from the lung to the chest wall with complicating pleural effusion and remained with organization because there was a pulmonary infiltration shadow in the right upper lobe on chest CT at the first admission.
Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, 577 Matsushima, 701-0192, Kurashiki, Japan. resp@med.kawasaki-m.ac.jp
Yoshihiro
Y
Kobashi
Kouichiro
K
Yoshida
Naoyuki
N
Miyashita
Yoshihito
Y
Niki
Toshiharu
T
Matsushima
D000196:Actinomycosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D013896:Thoracic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed