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

• Lethargy
  
• Weight loss
  
• fever
  
• cough with sputum
  
• draining sinuses
  
• night sweats
  
• Shortness of breath
  
• Chest pain

• 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

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

• sinus tracts in the neck, face, or chest
  
• brain abscess
  
• Meningitis
  
• Osteomyelitis
  
• Empyema

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

Prevention
Good dental hygiene helps prevent actinomycosis.

Medical Encyclopedia
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