Hemoptysis secondary to actinomycosis: A rare presentation.
We present a 70-year-old female patient who had the history of hypertension and presented with massive haemoptysis. She had been complaining of cough with expectoration and mild streaking of blood in sputum for about 3 days with only crepts in right infrascapular and infra-axillary regions as positive clinical findings. Bronchoscopy revealed a cauliflower-like lesion in the upper- right lobe bronchus; bronchial aspirate showed occasional colonies of gram positive filamentous bacteria surrounded by neutrophils. The Trucut biopsy showed sheets of neutrophils with colonies of filamentous bacteria consistent with actinomycotic infection. She was started on intravenous benzyl penicillin 20 million units 6 hourly. She recovered with no further bouts of hemoptysis and was discharged on amoxicillin + clavulanic acid in a stable condition and she remained under similar condition for more than a year on follow up. Actinomycosis is a rare disease caused by a harmless commensal species, Actinomyces. Diagnosis of actinomycosis is a challenging situation, and more so, very few cases causing hemoptysis have come to light so far.
Department of Respiratory Medicine, Critical Care and Sleep Disorders, Jaipur Golden Hospital, Rohini, Delhi, India.
Rakesh K
RK
Chawla
Department of Pulmonary Medicine, SMS and R and Sharda Hospital, Noida, Uttar Pradesh, India.
Arun
A
Madan
1st year PG Student, (MD Pulmonary Medicine), SRIMS, Bareilly, UP, India.
Aditya
A
Chawla
Deputy General Manager, Medical Operations and Quality Control, Saroj Hospital, Delhi, India.
Kiran
K
Chawla
Actinomycosis; Bronchoscopy; Hemoptysis