[Actinomycosis presenting as a chronic excavated pneumonia in a young woman]

Pulmonary actinomycosis is an anaerobic bacterial infection occurring primarily in debilated patients with poor oral hygiene. Before the penicillin era, thoracic actinomycosis looked like tuberculosis or neoplasia with chest wall invasion and fistula formation.

We report the case of a 39 years old woman presenting with a chronic lung abscess of the left upper lobe hospitalised after several unsuccessful courses of antibiotics. The diagnosis was made after thoracic surgery. Three years after lobectomy, which had been followed by three months of amoxycillin and multiple dental extractions, there was no sign of relapse of the infection.

We review the role of thoracic surgery, antibiotic treatment and diagnosis in pulmonary actinomycosis.