Actinomycosis pulmonary

Alternative names
Actinomycosis pulmonary

Definition
Pulmonary actinomycosis is a bacterial lung infection caused by actinomyces or propioni bacteria.

Causes, incidence, and risk factors

The organisms that cause this disease are normally found in the mouth and gastrointestinal tract, where they do not usually cause harm. Poor dental hygiene and dental abscess can predispose people to facial lesions and lung infections caused by these bacteria.

Actinomycosis in the lungs causes lung cavities, lung nodules, and pleural effusions. The infection can cross the normal tissue boundaries of the chest producing for example, draining sinuses through the muscles and skin of the chest wall. The disease is rare and may occur at any age, but most affected patients are 30-60 years old.

Men are affected more frequently than women.

Symptoms

Signs and tests

     
  • CBC showing anemia  
  • Chest x-ray  
  • chest CT scan  
  • culture of specific tissue  
  • bronchoscopy with culture  
  • surgical lung biopsy  
  • thoracentesis with culture  
  • specific tissue or fluid analysis for sulfur granules

Treatment

The objective of therapy is to control the infection, but response is slow. Prolonged therapy with penicillin or a substitute is necessary to ensure a cure. Surgical drainage of the pleural effusion may be necessary to control the infection.

Alternative antibiotics, such as tetracyclines, macrolides, or clindamycin, may be used in patients who cannot take penicillin.

Expectations (prognosis)
The probable outcome is good after treatment with antibiotics.

Complications

Calling your health care provider
Call your health care provider if symptoms of pulmonary actinomycosis develop.

Also call if symptoms worsen or do not improve with treatment, or if new symptoms develop.

Prevention
Good dental hygiene helps prevent actinomycosis.

Johns Hopkins patient information

Last revised: December 6, 2012
by Simon D. Mitin, M.D.

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