Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Actinomycosis
- Radiologic Findings
- Chest radiograph revealed ill-defined cavitary consolidation in the right upper lobe. High-resolution CT showed ill-defined consolidation with multiple cavities in right upper lobe. Contrast-enhanced CT scan showed multiple cavities and low-attenuation areas with enhancing rim in the consolidation.
Percutaneous CT-guided needle aspiration was performed and the histopathologic findings showed a typical sulfur granule containing Actinomyces colony surrounded by polymorphonuclear cells.
- Brief Review
- Thoracic Actinomycosis is an uncommon bacterial infection. The organisms are normal inhabitants of oropharynx and are frequently found at gingival margins of persons with poor oral hygiene. Usually, the spread of infection occurred directly from the oropharynx into the lung by aspiration.
The typical pattern of radiologic manifestation consists of air-space consolidation, without recognizable segmental distribution, commonly in the periphery of the lung and with a predilection for the lower lobes. Usually the infection may extend into the pleura and chest wall. Recently, chest wall involvement is rarely seen probably due to earlier diagnosis and more effective antibiotics treatment. Other atypical findings include a mass, frequently cavitated, miliary disease, multiple nodules, bilateral apical opacities and endobronchial nodule with obstructive pneumonopathy (1).
Thoracic CT findings were reported as findings of chronic segmental air-space consolidation that containing low-attenuation areas with peripheral enhancement or adjacent pleural thickening (2).
- References
- 1. Fraser RS, M?ler NL, Colman N, Par?PD. Diagnosis of disease of the chest. Philadelphia: Saunders, 1992; 952-957.
2. Cheon JE, Im JG, Kim MY, Lee JS, Choi GM, Yeon KM. Thoracic Actinomycosis: CT findings. Radiology 1998;209:229-233.
- Keywords
- Lung, Infection, Bacterial infection,