Lee C H, Lin M C, Tsai Y H, Tsao T C, Lan R S, Chiang Y C
Department of Pulmonary Medicine, Chang Gung Memroial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1991 Dec;14(4):246-52.
Nine cases of thoracic actinomycosis treated in the period from 1976 to 1990 were reviewed. Among them, 4 cases were children. The clinical symptoms and laboratory examinations were non-specific. Chest roentgenographic manifestations including nodular (3 cases), infiltrations (4 cases), and infiltrations with pleural changes (2 cases) were also non-specific. Chest wall masses were noted in four patients. There were no cases correctly diagnosed on admission. The diagnosis of thoracic actinomycosis was made from thoracotomy in 6 cases, from culture of chest wall mass incisional specimens in 2 cases and from bronchoscopic biopsy in 1. All the patients received antibiotics, however the varied duration of postoperative antibiotics did not change the outcome. No mortality or recurrence was noted in our 9 patients with a mean follow-up of 1.9 years (from 2 months to 6 years.) We conclude that surgical intervention is still the cardinal method for diagnosis and treatment. Establishment of the role of postoperative antibiotics will need further prospective study. The prognosis of thoracic actinomycosis is fairly good.
回顾了1976年至1990年期间治疗的9例胸段放线菌病病例。其中，4例为儿童。临床症状和实验室检查无特异性。胸部X线表现包括结节状（3例）、浸润性（4例）以及伴有胸膜改变的浸润性病变（2例），也均无特异性。4例患者出现胸壁肿块。入院时均无正确诊断病例。胸段放线菌病的诊断6例通过开胸手术，2例通过胸壁肿块切开标本培养，1例通过支气管镜活检确诊。所有患者均接受了抗生素治疗，然而术后抗生素使用的不同时长并未改变治疗结果。我们的9例患者平均随访1.9年（从2个月至6年），未观察到死亡或复发情况。我们得出结论，手术干预仍是诊断和治疗的主要方法。确定术后抗生素的作用还需要进一步的前瞻性研究。胸段放线菌病的预后相当良好。
