Pulmonary actinomycosis

Definition

Pulmonary actinomycosis is a lung infection caused by the bacteria actinomyces or propioni.

Causes, incidence, and risk factors

The organisms that cause actinomycosis are normally found in the mouth and gastrointestinal tract, where they do not usually cause harm. However, poor dental hygiene and dental abscess can increase a person's risk for face sores and lung infections caused by these bacteria.

Alcohol abuse is associated with actinomycosis.

Actinomycosis in the lungs causes lung cavities, lung nodules, and pleural effusions. The disease is rare and may occur at any age, but most patients are 30-60 years old. Men are more frequently affected than women.

Symptoms

• Lethargy
• Weight loss
• Fever
• Cough with sputum
• Draining sinuses
• Night sweats
• Shortness of breath
• Chest pain

Signs and tests

• CBC
• Chest x-ray
• Chest CT scan
• Culture of specific tissue
• Bronchoscopy with culture
• Lung biopsy
• Thoracentesis with culture
• Tissue and fluid analysis for sulfur granules

Treatment

The goal of treatment is to control the infection. However, many patients are slow to respond to treatment.  Long-term use of penicillin is needed to cure the condition. Alternative antibiotics such as tetracyclines, macrolides, or clindamycin may be used in patients who cannot take penicillin.

Surgery may be necessary to drain fluid from the lung area and control the infection.  

Expectations (prognosis)

The probable outcome is good after treatment with antibiotics.

Complications

• Brain abscess
• Meningitis
• Osteomyelitis
• Emphysema

Calling your health care provider

Call your health care provider if symptoms of pulmonary actinomycosis develop.

Also call if symptoms worsen or do not improve with treatment, or if new symptoms develop.

Prevention

Good dental hygiene helps prevent actinomycosis.

Illustrations

Respiratory system

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Actinomycosis pulmonary