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Science Forum Index » Medicine - Nursing Forum » Difficulty Diagnosing Actinomycosis From Lung Cancer
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| ironjustice |
 Posted: Sat Feb 02, 2008 6:43 am |
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Guest
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I wonder how many people with simple lung infection were killed by the
lab techs.
Much like the Nobel prize winning ulcer work which was ONLY discovered
when the lab techs went on .. holiday .. ?
Radiated everyone to death .. ?
Nihon Kokyuki Gakkai Zasshi. 2000 Mar;38(3):186-9. Links
[Pulmonary actinomycosis presenting as a mass lesion on chest X-ray
film]
[Article in Japanese]
Izumi Y, Moroe Y, Onaka A, Kato R, Hirose S.
Department of Pulmonary Medicine, National Tokyo Medical Center,
Japan.
A 61-year-old man presented with fever, productive cough, and
occasional blood-streaked sputum. Chest X-ray films disclosed a poorly
defined mass in the right middle lung field. A transbronchial lung
biopsy specimen showed epithelial changes indicative of lung cancer,
and a right lower lobectomy was performed. Because the resected
specimen contained a cavity filled with colonies of actinomycetes,
pulmonary actinomycosis was diagnosed. The cavity was surrounded by
inflammatory infiltrations and fibrosis with occasional atypical
epithelial changes suggestive of benign hyperplasia. Although
pulmonary actinomycosis is uncommon today, it deserves attention
because of the potential difficulty in differentially diagnosing it
from lung cancer.
PMID: 10846399 [PubMed - indexed for MEDLINE]
---------------------------------------
Rev Soc Bras Med Trop. 2007 Jan-Feb;40(1):82-5. Links
[Lung actinomycosis with chest wall involvement]
[Article in Portuguese]
Fatureto MC, Oliveira PF, Almeida CO, Fernandes LH.
Disciplina de Cirurgia Torácica, Departamento de Cirurgia,
Universidade Federal do Triângulo Mineiro, Uberaba, MG. mfat@terra.com
Actinomycosis is an uncommon suppurative granulomatous chronic
infection that may involve several organs. Lung infection is usually
related to immunodepression and poor oral hygiene. Cases of thoracic
involvement are rare (10 - 20%) and only 12% of such cases affect the
chest wall. This report describes the case of a 26-year-old HIV-
negative patient without comorbidities or respiratory complaints who
presented a very painful, progressively growing infrascapular mass,
with local phlogistic signs and no local trauma, and persistent fever.
It had been progressing for three months. The initial diagnosis was
neoplasia of chest wall soft tissue. However, incision biopsy in this
mass produced a red wine-colored gelatinous secretion containing
yellowish granules suggestive of actinomycosis, which was later
confirmed by anatomopathological examination. Ciprofloxacin was
instituted empirically because of cephalosporin allergy. There was an
excellent clinical response to external drainage and the prescribed
medication. Over the course of 18 months of follow-up, there was no
disease recurrence.
PMID: 17486262 [PubMed - indexed for MEDLINE]
-------------------
Br J Oral Maxillofac Surg. 1985 Dec;23(6):428-34. Links
Antibiotic treatment of cervicofacial actinomycosis for patients
allergic to penicillin: a clinical and in vitro study.
Martin MV.
The minimum inhibitory concentrations for erythromycin, clindamycin,
lincomycin, tetracycline and minocycline have been determined for 92
clinical and three culture collection isolates of Actinomyces. From a
consideration of MIC values and expected serum levels from oral
therapy, minocycline was the drug of choice for the treatment of
actinomycosis in patients allergic to penicillin. The serum levels of
six patients allergic to penicillin, treated with oral minocycline 1 g/
day were monitored and found to exceed the MIC for the Actinomyces
species responsible for the condition. In all six Actinomycosis cases
resolution was achieved in 8-16 weeks of oral minocycline therapy with
no recrudescence for 1 year.
PMID: 2933063 [PubMed - indexed for MEDLINE]
-------------------
Pneumologie. 1992 Jan;46(1):12-9. Links
[Thoracic actinomycosis versus bronchial cancer]
[Article in German]
Brombacher-Frey I, Wöckel W, Kreusser T.
Pneumologische Klinik, Zentralkrankenhauses Gauting, LVA Obb.
We report on 4 thoracic actinomycoses; in three of these four cases a
bronchial carcinoma was suspected, and in case No. 2 this carcinoma
had been considered to be in a very advanced and inoperable stage. A
man of 51 years of age was in a generally run-down condition. He also
noticed that his sputum was tinged with blood. The x-ray film showed a
large space-occupying growth at the right lung hilus. Repeated
perbronchial biopsies of the focus did not yield any diagnosis.
Actinomycosis was identified histologically only in the tissue samples
obtained via thoracotomy. After a three-month penicillin course the
hilar shadow receded. A 61-year old male patient was transferred to
our Pneumological Hospital, being strongly suspected of suffering from
an extensive bronchial carcinoma, and having multiple intrathoracic
space-occupying growths as well as pleural effusions, a pericardial
effusion, and an infiltration of the left thoracic wall with fistula
formation; however, histological examination of skin biopsies revealed
that he was suffering from actinomycosis. Antibiotic therapy cured him
completely in a six-month course. In a man of 32 years of age who had
been indulging for many years in a severe abuse of nicotin, we
suspected a central bronchial carcinoma on the basis of his x-ray, but
histology of the tissue taken from the space-occupying growth via
diagnostic thoracotomy revealed that this patient, too, suffered from
actinomycosis. Complete recession occurred after several months of
antibiotic treatment. A woman of 82 years had been an inpatient for
several months in another hospital because of relapsing
pleuropneumonias on the right side. She was transferred to us as an
outpatient after a renewed relapse. We conducted a transcutaneous fine-
needle biopsy of the right indurating pleural effusion. A few
actinomyces filaments were seen on histological examination of the
purulent exudate. Hence, actinomycosis was confirmed. After antibiotic
therapy the finding receded completely.
PMID: 1546057 [PubMed - indexed for MEDLINE]
--------------------
Korean J Intern Med. 2002 Sep;17(3):207-10. Links
Foreign body-induced actinomycosis mimicking bronchogenic carcinoma.
Kim YS, Suh JH, Kwak SM, Ryu JS, Cho CH, Park CS, Min SK.
Department of Internal Medicine, College of Medicine, Inha University,
Inha General Hospital, Songnam, 7336 Tae Pyuong-4 Dong, Sujong-Ku,
Songnam, Kyongkido 461-712, Korea.
Actinomycosis is a slowly progressive infectious disease caused by an
anaerobic and microaerophilic bacteria that colonizes the face, neck,
lung, pleura and the ileocecal region. There have been a few cases of
this disease which have involved in the lung but one very rare case
has been reported. We report a case of foreign body-induced
endobronchial actinomycosis mimicking bronchogenic carcinoma in a 69-
year-old man. On admission, the patient presented with weight loss,
cough and hemoptysis. The fiberoptic bronchoscopy revealed a soft
tissue mass, with a partial occlusion of the left upper bronchus,
which resembled bronchogenic carcinoma. Contrary to the first
impression, the biopsy of the bronchus revealed the mass lesion to be
an actinomycotic infection involving the bronchus. After the
confirmation of the lesion, treatment with penicillin was initiated.
The follow-up bronchoscopy revealed an aspirated fish bone at the site
of infection. The foreign body was safely removed.
PMID: 12298433 [PubMed - indexed for MEDLINE]
---------------------------------
CASE STUDY
Actinomycosis: An Often Forgotten Diagnosis
Randolph HL Wong, MRCS, Alan DL Sihoe, MRCS, KH Thung, FRCS, Innes YP
Wan, FRCS, Margaret BY Ip, MRCPath1, Anthony PC Yim, FRCS
Department of Surgery
1 Department of Microbiology, Prince of Wales Hospital, Hong Kong,
People's Republic of China
For reprint information contact: Anthony PC Yim, FACS Tel: 852 2632
2629 Fax: 852 2647 8273 Email: yimap@cuhk.edu.hk Division of
Cardiothoracic Surgery, Department of Surgery, The Chinese University
of Hong Kong, Shatin, Hong Kong, People's Republic of China.
We report a case of actinomycosis presenting as a chest wall mass in a
35 year-old man. Thoracic actinomycosis poses a diagnostic challenge
to clinicians not only because it is uncommon and often forgotten, but
also because culture of the causative microbes is technically
difficult. The classic microscopic appearance of this Gram-positive
bacteria associated with surrounding sulfur granules often forms the
basis of diagnosis.
------------------------------------
Br J Oral Maxillofac Surg. 1985 Dec;23(6):428-34. Links
Antibiotic treatment of cervicofacial actinomycosis for patients
allergic to penicillin: a clinical and in vitro study.
Martin MV.
The minimum inhibitory concentrations for erythromycin, clindamycin,
lincomycin, tetracycline and minocycline have been determined for 92
clinical and three culture collection isolates of Actinomyces. From a
consideration of MIC values and expected serum levels from oral
therapy, minocycline was the drug of choice for the treatment of
actinomycosis in patients allergic to penicillin. The serum levels of
six patients allergic to penicillin, treated with oral minocycline 1 g/
day were monitored and found to exceed the MIC for the Actinomyces
species responsible for the condition. In all six Actinomycosis cases
resolution was achieved in 8-16 weeks of oral minocycline therapy with
no recrudescence for 1 year.
PMID: 2933063 [PubMed - indexed for MEDLINE]
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://jesuswasavegetarian.7h.com
Man Is A Herbivore!
http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk |
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