Enders M, Reitnauer K, Girmann M, Lindemann W, Ukena D, Sybrecht G W
Medizinische Universitätsklinik, Innere Medizin II, Homburg/Saar.
Pneumologie. 1999 Apr;53(4):216-8.
Actinomycosis is caused by a variety of gram-positive anaerobic or microaerophilic rods belonging to the genus Actinomyces or Propionibacterium. The production of suppurative abscesses or granulomas that eventually develop draining sinuses are hallmarks of the disease. We describe the case of a 55 year old smoker who presented himself 4 months ago with right thoracic pain and an unproductive cough. He developed a warm, red mass in the lower part of the right thorax. We performed an ultrasound guided needle aspiration and the pathologic examination revealed typical sulfur granules and masses of neutrophils in the aspirate. After surgical resection of the abscess and under high-dose therapy with penicillin G the further course of disease was uneventful.
Although uncommon, thoracic actinomycosis should always taken into account in the differential diagnosis of chronic inflammatory processes that involve the pulmonary parenchyma or pleural space.
放线菌病由多种属于放线菌属或丙酸杆菌属的革兰氏阳性厌氧或微需氧杆菌引起。产生化脓性脓肿或肉芽肿并最终形成引流窦道是该疾病的特征。我们描述了一名55岁吸烟者的病例,他4个月前出现右胸痛和干咳。他在右胸下部出现了一个温暖、发红的肿块。我们进行了超声引导下针吸活检,病理检查显示吸出物中有典型的硫磺颗粒和大量中性粒细胞。在脓肿手术切除并接受大剂量青霉素G治疗后,疾病的进一步发展过程平稳。
尽管罕见,但在涉及肺实质或胸膜腔的慢性炎症过程的鉴别诊断中,应始终考虑到胸段放线菌病。