title: Nonresolving pneumonia.
abstract: A 58-year-old man admitted for evaluation of weight loss and dry cough. Initially, he was diagnosed with community-acquired pneumonia. Despite receiving antibiotics, his clinical status deteriorated and was intubated. Fiber optic bronchoscopy revealed a significant amount of mucopurulent secretions. Bronchoalveolar lavage showed marked amount of sulfur granules identified on stain. Microbiology culture was compatible with Actinomyces israelii. Pulmonary actinomycosis is a rare but important and challenging diagnosis to make. It presents with wide spectrum of clinical and radiologic characteristics. Failure to recognize the disease early may result in drastic complications.
authors.affiliation: Department of Medicine, Chicago Medical School/Rosalind Franklin, University of Medicine and Science, Chicago, IL, USA. fmk01@hotmail.com
authors.forename: Fayez
authors.initials: F
authors.lastname: Kheir
authors.forename: Tamim
authors.initials: T
authors.lastname: Hamdi
authors.forename: Walid
authors.initials: W
authors.lastname: Khayr
authors.forename: Shadi
authors.initials: S
authors.lastname: Latta
mesh_terms: D000190:Actinomyces / Q000302:isolation & purification*; D000196:Actinomycosis / Q000175:diagnosis* / Q000382:microbiology; D018893:Bronchoalveolar Lavage / Q000379:methods; D001999:Bronchoscopy / Q000379:methods; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000382:microbiology; D005336:Fiber Optic Technology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis* / Q000382:microbiology