Bronchopulmonary actinomycosis associated with hiatal hernia

Area of Science:

• Pulmonology
• Infectious Diseases
• Radiology

Background:

• Bronchopulmonary actinomycosis is a rare infection.
• It often mimics pulmonary malignancy on clinical and radiologic assessments.
• Accurate diagnosis requires detailed patient history and histopathologic examination.

Purpose of the Study:

• To describe the clinicoradiologic and histopathologic features of bronchopulmonary actinomycosis.
• To investigate potential predisposing factors for this condition.
• To determine if hiatal hernia (HH) is associated with bronchopulmonary actinomycosis.

Main Methods:

• Retrospective review of medical charts for 10 patients diagnosed with bronchopulmonary actinomycosis between November 2002 and January 2008.
• Assessment of clinical data, chest radiographs, computed tomographic (CT) scans, and histopathologic findings.
• Evaluation for potential predisposing factors, including hiatal hernia.

Main Results:

• The study included 10 patients (6 men, 4 women; mean age 63.5 years), with 8 smokers.
• Common symptoms included cough and fever. Imaging revealed mass-like consolidation, bronchial thickening, or atelectasis.
• Eight patients were initially suspected of having lung cancer. Six patients had foreign body-related endobronchial actinomycosis, and 5 of these also had hiatal hernia (HH).

Conclusions:

• Bronchopulmonary actinomycosis is a rare entity that can be mistaken for pulmonary malignancy.
• Diagnosis depends on clinical history and histopathology.
• Esophageal hiatal hernia (HH) is suggested as a potential predisposing factor, warranting further investigation.