title: Pulmonary actinomycosis presenting with prolonged fever and massive hemoptysis: a case report.
abstract: We present a rare case of pulmonary actinomycosis complicated with massive hemoptysis. The patient was a 41-year-old male farmer, who had experienced prolonged fever and off-and-on blood streaked sputum for 2 years. He was admitted to our hospital because of 3 days of massive hemoptysis. He had no underlying medical illnesses, but was a heavy smoker and an alcoholic. The chest radiograph revealed patchy alveolar infiltration of the right upper lobe, mimicing tuberculosis. Massive hemoptysis was not controlled using conservative treatment and anti-tuberculous drugs. Emergency right upper lobe lobectomy was needed to stop the bleeding. Histopathologic examination demonstrated aggregates of filamentous gram-positive organisms in characteristic "sulfur granules", indicating actinomycosis. The fever subsided after intravenous augmentin was given, followed by 6 months of oral amoxicillin. The patient is doing well and has had no recurrent hemoptysis.
authors.affiliation: Department of Medicine, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Thailand.
authors.forename: Wipa
authors.initials: W
authors.lastname: Reechaipichitkul
authors.forename: Thitiporn
authors.initials: T
authors.lastname: Napaprasit
authors.forename: Anucha
authors.initials: A
authors.lastname: Puapairoj
authors.forename: Sompop
authors.initials: S
authors.lastname: Prathanee
mesh_terms: D000190:Actinomyces / Q000472:pathogenicity; D000196:Actinomycosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D005334:Fever / Q000150:complications* / Q000503:physiopathology; D006469:Hemoptysis / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008171:Lung Diseases; D008297:Male; D013785:Thailand; D016896:Treatment Outcome