Pulmonary actinomycosis Case report and retrospective analysis of the literature in China

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1、Pulmonaryactinomycosis:CasereportandretrospectiveanalysisoftheliteratureinChinaBaiquanYu1*,YaxinLiu1*,FuzhenLv1#1DepartmentofRespiratory,theSecondAffiliatedHospitalofHarbinMedicalUniversity,Harbin,150081,China*Thesetwoauthorscontributeequallytothiswork.#Co

2、rrespondingAuthor:Fuzhenlv,M.D.,Ph.D.Emailaddresses:BaiquanYu:yubaiquan76@163.comYaxinLiu:aliu0707@126.comFuzhenLv:lvfuzhen01@yahoo.cnAbstract:Pulmonaryactinomycosisisararebutfrequentlymisdiagnoseddiseasethatiscommonlyconfusedwithotherchronicinflammatorydi

3、seasesandmalignancies.Inthisreport,weaimedtoevaluatetheclinicalmanifestationsandimagingfeaturesofpulmonaryactinomycosisforearlyrecognitionwhichcouldpreventtheconsiderablephysicaldamagecausedbydelayeddiagnosis.Wereporteda52-year-oldChineseman,sufferedbya15-

4、dayhistoryofcough,copiouspurulentsputumandintermittentfever,wasfinaldiagnosedaspulmonaryactinomycosisbyB-modeultrasonic-guidedtransthoracicneedlebiopsy.Then24confirmedcases,includingourpatientfromyear2005to2010,werereviewedandtheirclinicalmanifestations,di

5、agnosisandtreatmentwereanalyzed.Inourseriesthemedianageofthepatientswas46.5years,andthemale-to-femaleratiowas3:1.Themostcommonsymptomsincludecough,sputum,haemoptysis,feverandchestpain.Themainradiologicalfeatureswereperipheralmassornodulecomplicatedcavity,b

6、urr,pleuraleffusion.Malignancypossessedthehighestrateformisdiagnosis(33.3%),followedbypneumonia(25%)andtuberculosis(16.7%)amongthesecases.Patientswereconfirmedbyfiberopticbronchoscopy(20.8%),transthoracicneedlebiopsy(33.3%),orsurgery(33.3%).Withregardtothe

7、treatment,12cases(50%)weretreatedbyantibioticsonlyand5cases(20.8%)bysurgeryonly,and4cases(16.7%)bysurgerycombinedwithantibiotics.Whenamiddle-agedmalepatientpresentswithcough,sputumandhaemoptysis,togetherwithradiologicfindingsofaperipheralmassormediastinally

8、mphadenopathy,respiratoryphysiciansshouldsuspectpulmonaryactinomycosisandgivethepropertreatmenttopreventunwarrantedsurgeryorunnecessarydeath.Keywords:Actinomyces,pulmomaryactinomycosis,bronchoscopy,antibiotic