Ayadi-Kaddour A, Mlika M, Marghli A, Braham E, Kilani T, El Mezni F
Service d'anatomie et de cytologie pathologiques, département d'anatomopathologie, hôpital Abderrahmen-Mami, 2080 Ariana, Tunisie.
Med Mal Infect. 2008 Apr;38(4):225-7. doi: 10.1016/j.medmal.2008.02.002. Epub 2008 Apr 9.
Thoracic actinomycosis is a suppurative infection which can be difficult to diagnose as its presentation may mimic cancer or tuberculosis. We report a new case of thoracic actinomycosis in a 35-year-old man who presented with thoracic symptoms associated to a productive parietal fistula. Imaging exploration revealed an opacity of the right ventroapical segment with parietal infiltration. A bilobectomy and a parietectomy were performed. The anatomopathologic diagnosis actinomycosis was confirmed. The patient was first put on a treatment of azathioprine 1g daily during two weeks, then switched to a combination with Vibramycin 100 mg twice a day during 17 months, The evolution was marked by the persistence of productive fistulae, which were treated surgically, and resistance to the initial treatment leading to a switch to Augmentin 3 g daily during 25 days. The patient experienced clinical improvement with a follow up of 18 months than was lost to follow-up.
