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[Primary bronchial actinomycosis and foreign body]
H Mingrone1, R Perrone, S La Rosa
1Hospital de Enfermedades Infecciosas F. J. Muñiz, Buenos Aires, Argentina.
Abstract:
This paper presents the fourth case reported on the association of primary bronchial actinomycosis and foreign body. The pathogenesis of this rare association has been linked to the low respiratory tract and a foreign body (chicken bone); it depends on its characteristics and how long it has remained lodged into the bronchial tree. The diagnosis of this case was very difficult and late. Several endoscopy procedures were required in order to detect it. Our patient has been treated successfully with parenteral penicillin in association with an original bronchoscopic procedure using a laser technique to find the foreign body and take it out of the respiratory tract. We consider that it is necessary to remember this association in every patient who suffers from recurrent pneumonia, in those who are at risk of foreign body aspiration and when the presence of an endobronchial mass is suspected.
Insights
This rare case highlights bronchial actinomycosis linked to a foreign body, often a chicken bone, causing diagnostic challenges. Successful treatment involved antibiotics and laser bronchoscopy for foreign body removal.
Area of Science:
- Pulmonology
- Infectious Diseases
- Medical Case Reports
Background:
- Bronchial actinomycosis is a rare fungal infection of the lungs.
- Foreign body aspiration into the bronchial tree can lead to complications.
- The association between primary bronchial actinomycosis and foreign bodies is exceptionally uncommon.
Observation:
- A challenging case of bronchial actinomycosis associated with a retained chicken bone foreign body is presented.
- Diagnosis was significantly delayed, requiring multiple endoscopic interventions.
- The patient presented with symptoms suggestive of recurrent pneumonia.
Findings:
- The pathogenesis involves the interaction of the fungus with the foreign body in the lower respiratory tract.
- Successful treatment combined parenteral penicillin with a novel laser-assisted bronchoscopic foreign body extraction.
- This approach effectively removed the obstructing agent and treated the infection.
Implications:
- Clinicians should consider this rare association in patients with recurrent pneumonia or suspected foreign body aspiration.
- Endobronchial masses may represent underlying foreign bodies or associated infections.
- Early diagnosis and intervention are crucial for favorable outcomes in such complex cases.