title: Endobronchial actinomycosis after airway stenting.
abstract: Actinomycosis is a chronic suppurative infection with filamentous, gram-positive, nonspore forming anaerobic bacteria of the genus Actinomyces. Actinomyces species are commensals of the human oropharynx, gastrointestinal tract, and female genitalia. Involvement of the thorax accounts for 15% to 20% of actinomycosis cases. Thoracic actinomycosis classically presents as an intrapulmonary infection of the alveoli, peribronchial tissue, and/or bronchioles. Endobronchial actinomycosis is a rare condition that has been reported in association with aspiration of a foreign body or broncholithiasis. A critical component in the pathogenesis is disruption of the mucosal barrier, thereby allowing invasion of the microorganisms from aspirated oropharyngeal secretions. Even with a high clinical suspicion, actinomycosis is a diagnostic challenge. The most common symptoms of endobronchial actinomycosis include cough, sputum production, and fever. The disease is often confused with lung cancer, tuberculosis, fungal infections, nocardiosis, and poorly responding pneumonia. The present case highlights the first reported case of endobronchial actinomycosis associated with a covered nitinol endobronchial stent.
authors.affiliation: Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI 48202, USA. agodfre1@hfhs.org
authors.forename: Amanda M K
authors.initials: AM
authors.lastname: Godfrey
authors.forename: Javier
authors.initials: J
authors.lastname: Diaz-Mendoza
authors.forename: Cynthia
authors.initials: C
authors.lastname: Ray
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Simoff
mesh_terms: D000196:Actinomycosis; D001984:Bronchial Neoplasms / Q000601:surgery; D001991:Bronchitis / Q000382:microbiology*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008172:Lung Diseases, Fungal / Q000382:microbiology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography / Q000379:methods; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D015607:Stents / Q000009:adverse effects*