[Three patients with thoracic actinomycosis]
I Krivokuca1, D W de Lange, J-W J Lammers
1Universitair Medisch Centrum Utrecht, Afd. Longziekten, Utrecht.
Abstract:
Thoracic actinomycosis was diagnosed in 3 patients. A 39-year-old man with no relevant medical history was admitted with syncope and hemiparesis. Radiological examination of the thorax and cerebrum revealed abnormalities. The second patient was a 50-year-old man with pneumonia that had not responded to multiple courses of different antibiotics. The third patient was a 42-year-old man admitted for evaluation and treatment of hepatopulmonary abnormalities. Actinomyces was cultured from purulent material obtained under anaerobic conditions as far as possible from the first 2 patients; the third patient was diagnosed by histopathological examination. All 3 patients recovered completely after long-term antibiotic therapy. Actinomycosis remains a diagnostic challenge due to the inherent difficulties in culturing anaerobic bacteria. In addition, false-positive results are possible because Actinomyces is present in the oropharynx, digestive tract and female genital tract under normal conditions.
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