Sando Y, Sugita Y, Kaneko K, Ubukata M, Motegi M, Takayanagi N
Saitama Ohara Sanatorium, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Oct;30(10):1869-73.
Three cases of pulmonary actinomycosis are reported. Case 1 was a 33-year-old man complaining of hemosputum. A large mass lesion was noted in the right upper lobe and surgically resected. Actinomycosis was diagnosed pathologically. The second case was a 41-year-old man with lung abscess. An actinomyces species was cultured by percutaneous aspiration biopsy. He was effectively treated with clindamycin. The third case was a 46-year-old man with a chronic cough and cavitary lesion. Gram staining of sputum revealed sulfur granules. Piperacillin was administered with prompt response. All three cases had dental disease and two had diabetes mellitus. In patients with a mass lesion or those with lung abscess not effectively treated by cephem antibiotics, actinomycosis should be suspected especially when diabetes mellitus and/or dental disease coexists. Adequate treatment may not always require long-term antibiotics.
报告了3例肺放线菌病病例。病例1为一名33岁男性，主诉咯血。右上叶发现一个大的肿块病变，经手术切除。病理诊断为放线菌病。第二例是一名41岁患有肺脓肿的男性。通过经皮穿刺活检培养出一种放线菌。他接受克林霉素治疗后效果良好。第三例是一名46岁患有慢性咳嗽和空洞性病变的男性。痰液革兰氏染色显示有硫磺颗粒。给予哌拉西林治疗后迅速见效。所有3例患者均有牙齿疾病，2例患有糖尿病。对于有肿块病变的患者或用头孢菌素类抗生素治疗无效的肺脓肿患者，尤其当合并糖尿病和/或牙齿疾病时，应怀疑放线菌病。充分的治疗不一定总是需要长期使用抗生素。
