Diagnosis and Treatment of Endobronchial Actinomycosis.
10.4046/trd.2005.58.6.576
- Author:
Jae Chol CHOI
1
;
Won Jung KOH
;
Yong Soo KWON
;
Yon Ju RYU
;
Chang Min YU
;
Kyeongman JEON
;
Eun Hae KANG
;
Gee Young SUH
;
Man Pyo CHUNG
;
Hojoong KIM
;
O Jung KWON
;
Tae Sung KIM
;
Kyung Soo LEE
;
Joungho HAN
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wjkoh@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Actinomycosis;
Bronchoscopy;
Anti-bacterial agents
- MeSH:
Actinomyces;
Actinomycosis*;
Anti-Bacterial Agents;
Bronchoscopy;
Cough;
Diagnosis*;
Humans;
Lung Neoplasms;
Pneumonia;
Pulmonary Atelectasis;
Radiography, Thoracic;
Recurrence;
Retrospective Studies;
Sputum;
Tomography, X-Ray Computed;
Tuberculosis
- From:Tuberculosis and Respiratory Diseases
2005;58(6):576-581
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Thoracic actinomycosis is a relatively uncommon anaerobic infection caused by Actinomyces israelii. There have been only a few case reports of endobronchial actinomycosis. The aim of this study was to evaluate the clinical manifestation and treatment of endobronchial actinomycosis. MATERIAL AND METHODS: Seven patients with endobronchial actinomycosis, who were diagnosed in the past 10 years, were retrospectively reviewed. RESULTS: Cough and sputum were the most common symptoms. The chest radiograph and computed tomography showed necrotic consolidation (n=3), atelectasis (n=2), mass (n=1) and an endobronchial nodule (n=1). Proximal broncholithiasis was observed in five patients. All cases were initially suspected to have either lung cancer or tuberculosis. In these patients, the median duration of intravenous antibiotics was 3 days (range 0-12 days) and the median duration of oral antibiotics was 147 days (range 20-412 days). Two patients received oral antibiotic therapy only. There was no clinical evidence of a recurrence. CONCLUSION: Endobronchial actinomycosis frequently manifests as a proximal obstructive calcified endobronchial nodule that is associated with distal post-obstructive pneumonia. The possibility of endobronchial actinomycosis is suggested when findings of broncholithiasis are present at chest CT. The traditional recommendation of 2-6 weeks of intravenous antibiotics and 6-12 months of oral antibiotic therapy are not necessarily essential in all cases of endobronchial actinomycosis.
