Abstract
A 50-year-old female with diabetes mellitus was admitted to our hospital because of recurrent hemoptysis. Chest computed tomography revealed a mass with air cavities and wall thickness. A blood test showed a systemic inflammatory reaction and the level of plasma aspergillus antigen was high. Initially, she was diagnosed with chronic necrotic pulmonary aspergillosis and administered an anti-fungal agent. Because the hemoptysis did not improve, she underwent right upper lobectomy as a curative surgery. Post-operative pathological findings showed fine hyphae in the removed materials but did not show the fungal body of Aspergillus. She was diagnosed with pulmonary actinomycosis. She has been well without any recurrent lesions for four years since surgery followed by one-year penicillin treatment. Pulmonary actinomycosis is often too difficult to definitively diagnose, because it is often necessary to distinguish it from lung cancer, pulmonary tuberculosis, and fungal infection. Cases of pulmonary actinomycosis with massive hemoptysis and pulmonary nodules may require early diagnosis and treatment.
