Dujneungkunakorn T, Riantawan P, Tungsagunwattana S
Division of Medicine, Central Chest Hospital, Ministry of Public Health, Nonthaburi, Thailand.
J Med Assoc Thai. 1999 Jun;82(6):531-5.
Actinomycosis is a relatively rare infection. This is a report of 16 patients with pulmonary actinomycosis diagnosed from 1990 to 1997 at the Central Chest Hospital, Thailand. Twelve patients were male and 4 were female, with a mean age of 59 years and a mean duration of symptoms of 9 months. Common symptoms were cough and hemoptysis. Mass-like shadowing was the most common radiographic finding (37%). The diagnosis, based on findings of typical sulfur granules, was reached by bronchoscopy (10 cases), surgery (5 cases) and fine needle aspiration (1 case). Endobronchial mass with luminal occlusion was the most frequent bronchoscopic finding (56%). Coexistent bronchial carcinoma was present in one specimen. Penicillin was given in 10 patients, 2 of whom (20%) were cured, 5 (50%) are currently on treatment and have achieved clinical response, whereas, the other 2 patients (20%) did not respond. Surgical resection was performed in 8 patients, all of whom recovered. An awareness of the full spectrum of actinomycosis manifestations will expedite diagnosis and optimize treatment.
放线菌病是一种相对罕见的感染性疾病。本文报告了1990年至1997年期间在泰国中央胸部医院确诊的16例肺放线菌病患者。其中男性12例，女性4例，平均年龄59岁，平均症状持续时间为9个月。常见症状为咳嗽和咯血。块状阴影是最常见的影像学表现（37%）。基于典型硫黄颗粒的发现，通过支气管镜检查（10例）、手术（5例）和细针穿刺抽吸（1例）做出诊断。支气管腔内肿物伴管腔阻塞是最常见的支气管镜检查发现（56%）。有一个标本中并存支气管癌。10例患者接受了青霉素治疗，其中2例（20%）治愈，5例（50%）目前正在接受治疗且已取得临床疗效，而另外2例患者（20%）无反应。8例患者接受了手术切除，均康复。了解放线菌病的全部表现将有助于加快诊断并优化治疗。
