Actinomycosis With Pulmonary and Hepatic Involvement: A Case Report and Clinical Insights

Actinomycosis is a rare, chronic infectious disease caused by Actinomyces spp., characterized by an indolent and slowly progressive course. It represents a diagnostic challenge since its nonspecific clinical features often lead to misdiagnosis, mimicking pathologies such as solid neoplasms, active tuberculosis, nocardiosis, fungal infections, or other granulomatous diseases. This study describes a 56-year-old male with abdominal and thoracic pain, weight loss, fever, and dyspnea, over a two-week period. Imaging revealed the presence of hepatic abscesses and right-sided pleural effusion. Actinomyces odontolyticus was isolated in one sample of blood culture. Management included drainage of the mentioned hepatic and pleural collections, combined with prolonged antibiotic therapy, leading to significant clinical, laboratory, and radiological improvement. This case sheds light on the complexities inherent in diagnosing and treating actinomycosis, underscoring the importance of a multidisciplinary approach in managing complex presentations of this rare disease.