Diagnosis and treatment of endobronchial actinomycosis

Jae Chol Choi, Won Jung Koh, Yong Soo Kwon, Yon Ju Ryu, Chang Min Yu, Kyeongman Jeon, Eun Hae Kang, Gee Young Suh, Man Pyo Chung, Hojoong Kim, O. Jung Kwon, Tae Sung Kim, Kyung Soo Lee, Joungho Han

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Thoracic actinomycosis is a relatively uncommon anaerobic infection caused by Actinomyces israelii. There have been only a few case reports of endobronchial actinomycosis. The aim of this study was to evaluate the clinical manifestation and treatment of endobronchial actinomycosis. Material and Methods: Seven patients with endobronchial actinomycosis, who were diagnosed in the past 10 years, were retrospectively reviewed. Results: Cough and sputum were the most common symptoms. The chest radiograph and computed tomography showed necrotic consolidation (n=3), atelectasis (n=2), mass (n=1) and an endobronchial nodule (n=1). Proximal broncholithiasis was observed in five patients. All cases were initially suspected to have either lung cancer or tuberculosis. In these patients, the median duration of intravenous antibiotics was 3 days (range 0-12 days) and the median duration of oral antibiotics was 147 days (range 20-412 days). Two patients received oral antibiotic therapy only. There was no clinical evidence of a recurrence. Conclusion: Endobronchial actinomycosis frequently manifests as a proximal obstructive calcified endobronchial nodule that is associated with distal post-obstructive pneumonia. The possibility of endobronchial actinomycosis is suggested when findings of broncholithiasis are present at chest CT. The traditional recommendation of 2-6 weeks of intravenous antibiotics and 6-12 months of oral antibiotic therapy are not necessarily essential in all cases of endobronchial actinomycosis.

Original languageEnglish
Pages (from-to)576-581
Number of pages6
JournalTuberculosis and Respiratory Diseases
Volume58
Issue number6
DOIs
StatePublished - Jun 2005

Keywords

  • Actinomycosis
  • Anti-bacterial agents
  • Bronchoscopy

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