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Thoracic actinomycosis.

C B Sarker1, S Rahman, N I Siddiqui

  • 1Department of Medicine, Mymensingh Medical College, Mymensingh. cnsarker@yahoo.com

Mymensingh Medical Journal : MMJ
|January 30, 2004
PubMed
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Thoracic actinomycosis, a rare cause of chest disease, can manifest as isolated pleural effusion. This case highlights diagnosis via sulfur granules and treatment success with penicillin.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Pulmonology

Background:

  • Thoracic actinomycosis accounts for approximately 25% of all actinomycosis cases.
  • Isolated pleural effusion as a presentation of actinomycosis is uncommon.

Observation:

  • A case of right-sided pleural effusion with a discharging sinus on the anterior chest wall was observed.
  • Clinical suspicion of actinomycosis was raised based on the presentation.

Findings:

  • Microscopic identification of characteristic "sulfur granules" in the sinus discharge confirmed the diagnosis.
  • Gram-positive filamentous bacteria were identified in the discharge specimen.
  • The patient showed clinical and radiological improvement following treatment.

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Implications:

  • This case underscores the importance of considering actinomycosis in the differential diagnosis of pleural effusion and chest wall sinus tracts.
  • Successful treatment with penicillin G (intravenous followed by oral) and pleural fluid aspiration was demonstrated.
  • Early diagnosis and appropriate antibiotic therapy are crucial for favorable outcomes in thoracic actinomycosis.