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Pulmonary Actinomycosis in a Patient with AIDS/HCV

Payam Tabarsi1, Sootiya Yousefi2, Sayena Jabbehdari2

  • 1Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis, Tehran, Iran.

Journal of Clinical and Diagnostic Research : JCDR
|August 3, 2017
PubMed

Insights

Pulmonary actinomycosis, a rare lung infection, can mimic other diseases. This case highlights surgical intervention for massive hemoptysis due to an endobronchial mass, followed by successful antibiotic treatment.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Microbiology

Background:

  • Pulmonary actinomycosis is a rare bacterial lung infection caused by Actinomyces species.
  • It presents with diverse symptoms, often mimicking other pulmonary conditions, complicating diagnosis.
  • Early diagnosis is crucial as the infection can lead to significant lung destruction.

Observation:

  • A middle-aged male patient with AIDS/HCV presented with massive hemoptysis and progressive dyspnea.
  • Bronchoscopy revealed an endobronchial mass occluding the right upper lobe bronchus.
  • Initial conservative and penicillin treatments were ineffective for the severe bleeding.

Findings:

  • Histopathologic examination confirmed pulmonary actinomycosis by identifying filamentous Gram-positive organisms forming characteristic sulfur granules.
  • Surgical intervention (right upper lobectomy) was necessary to control the life-threatening hemoptysis.
  • Post-operative treatment with oral amoxicillin for six months led to complete recovery without recurrence.

Implications:

  • This case underscores the importance of considering rare infections like actinomycosis in patients with atypical pulmonary presentations.
  • Aggressive management, including surgery, may be required for severe, life-threatening complications such as massive hemoptysis.
  • Successful eradication of the infection with antibiotics post-surgery highlights the need for comprehensive treatment strategies.
Keywords:
HemoptysisImmunodeficiencyLungOpportunistic infections

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