2014 Volume 36 Issue 5 Pages 475-480
Background. It is difficult to diagnose pulmonary actinomycosis via trans-bronchial lung biopsy. Case. A 52-year-old woman complaining of a cough and chest pain was referred to our hospital. Chest X-ray films and CT scans showed a nodular shadow with infiltration in the left lung. A trans-bronchial lung biopsy failed to obtain sufficient material for diagnosis, and the bronchoalveolar lavage fluid was negative for both bacteria and malignant cells, with no abnormalities. The nodular shadow did not respond to treatment with penicillin. A microscopic examination of the nodular lesion obtained via left upper lobectomy showed branching filamentous bacteria, compatible with a diagnosis of actinomycosis. Conclusions. Pulmonary actinomycosis should therefore be considered in the differential diagnosis of nodular shadows on chest X-ray films and CT scans.
