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[Thoracic actinomycosis: Thinking of it earlier?]
S Faillon1, F Dubos2, C Thumerelle3
1Pôle de l'urgence, urgences pédiatriques et maladies infectieuses, hôpital Roger-Salengro, CHRU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France.
Unlabelled:
Thoracic actinomycosis is a rare disease, with high morbidity related to delayed diagnosis.
Objectives:
To identify and analyse paediatric thoracic actinomycosis to promote earlier diagnosis.
Design:
A 10-year descriptive retrospective review (1999-2008). Clinical, biological, and radiological data were collected and compared to identify common signs.
Results:
Three patients were identified. The time to diagnosis varied from 4 months to 3 years. Fever, asthenia, pain, weight loss, and sweats were the most common complaints. A predisposing factor was systematically observed. Irregular subpleural nodules were revealed with an infiltrative aspect. Definitive diagnosis was always histological.
Conclusion:
Actinomycosis should be sought in patients with asthenia and weight loss, local pain, when chest radiological evidence of distal nodules is observed with a non-specific biologic inflammatory syndrome. At this time, anaerobic bacteriological tests and histology should be performed.
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The first classification is based on the development of the disease, and it includes the following categories:
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