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[Actinomyces empyema treated with decortications].

Michal Shteinberg1, Shoshan Perek, Nesrin Ghanem

  • 1Pulmonary Unit, Carmel Medical Center, Haifa, Israel. michaldan@bezeqint.net

Harefuah
|May 24, 2012
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Actinomyces meyeri, a rare bacterial infection, caused a 66-year-old woman's shortness of breath and pleural effusion. Successful treatment involved ampicillin and surgical decortication, highlighting the importance of considering actinomycosis in difficult diagnoses.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pulmonology

Background:

  • Actinomyces infections are uncommon, affecting various body parts including the head, neck, abdomen, and lungs.
  • These infections are often overlooked due to their rarity and diagnostic challenges.
  • Actinomycosis diagnosis requires specific microbiologic techniques, often leading to delayed recognition.

Observation:

  • A 66-year-old woman presented with shortness of breath and pleural effusion.
  • Actinomyces meyeri was identified as the causative agent through culture and confirmed via polymerase chain reaction (PCR).
  • Initial treatments were insufficient, necessitating further intervention.

Findings:

  • The patient's condition improved significantly after treatment with ampicillin combined with surgical decortication.
  • This case underscores the diagnostic difficulties associated with Actinomyces infections.
  • Surgical intervention was crucial for a successful outcome in this patient.

Implications:

  • Early and accurate diagnosis of actinomycosis is critical for effective treatment.
  • Physicians should consider Actinomyces infections in patients with persistent, unexplained symptoms, especially in the thoracic cavity.
  • This case highlights the successful management of a rare Actinomyces infection using a combination of antibiotics and surgery.