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[Lung actinomycosis with chest wall involvement].

Marcelo Cunha Fatureto1, Paulo Fernando Oliveira, Cynthia Ottaiano R Almeida

  • 1Disciplina de Cirurgia Torácica, Departamento de Cirurgia, Universidade Federal do Triângulo Mineiro, Uberaba, MG. mfat@terra.com

Revista Da Sociedade Brasileira De Medicina Tropical
|May 9, 2007
PubMed
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This case report highlights actinomycosis, a rare chest wall infection, in an immunocompetent patient. Prompt diagnosis and treatment led to complete recovery without recurrence.

Area of Science:

  • Infectious Diseases
  • Medical Case Reports
  • Surgical Pathology

Background:

  • Actinomycosis is a rare, chronic bacterial infection characterized by suppurative granulomas.
  • Thoracic actinomycosis, particularly involving the chest wall, is uncommon, typically associated with compromised immunity or poor oral hygiene.
  • This case presents an unusual instance in an immunocompetent individual.

Observation:

  • A 26-year-old, HIV-negative patient without comorbidities presented with a painful, progressive infrascapular mass and fever.
  • Initial differential diagnosis included soft tissue neoplasia of the chest wall.
  • Incisional biopsy revealed characteristic sulfur granules in a gelatinous secretion, leading to a diagnosis of actinomycosis.

Findings:

  • The patient received empirical ciprofloxacin due to cephalosporin allergy.

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  • Combined external drainage and antibiotic therapy resulted in an excellent clinical response.
  • No recurrence was observed during an 18-month follow-up period.

    • Implications:

    • This case underscores the importance of considering actinomycosis in the differential diagnosis of chest wall masses, even in immunocompetent patients.
    • Early diagnosis and appropriate management, including surgical drainage and antibiotics, are crucial for successful outcomes.
    • Highlights the diagnostic value of identifying sulfur granules in clinical specimens.