Actinomyces and Lung: A Rare Association

Abstract

Introduction: Actinomycosis is a chronic bacterial infec- tion that rarely affects the respiratory system. Lung infection usually develops after aspiration of oropharyngeal or gastrointestinal secretions. Typically, it presents with pneumonia, lung abscess or empyema, and the most common radiologic presentation is a pulmonary mass, simulating a tumour. Adequate treatment requires prolonged antibiotic therapy to prevent relapse. In this article we made a literature review on actinomycosis and analysed patients’ data from Pedro Hispano Hospital.

Methods: Medical records from twelve-year data (January 2006 - December 2017) on pulmonary actinomycosis were consulted. Demographic and clinical data were retrospectively collected and analysed.

Results: Five patients were diagnosed with pulmonary actinomycosis, three males and two females. Mean age was 55 years. The most frequent microorganism was Actinomyces meyeri, identified in bronchoalveolar lavage in one case, and pleural fluid samples in other two cases. The other patients had isolation of Actinomyces odontolyticus and Actinomyces spp. All presented favourable response to treatment except for one patient, who died from empyema with septic shock. In one case, after a good therapeutic response, there was abandonment of the consultation and follow-up could not be maintained.

Conclusion: Presently, actinomycosis is a rare disease with good prognosis if diagnosed early and treated appropriately. It should always be considered as a differential diagno- sis of a persistent parenchymal lung lesion.