Yeung V H W, Wong Q H Y, Chao N S Y, Leung M W Y, Kwok W K
Division of Pediatric Surgery, Department of Surgery, Queen Elizabeth Hospital, Kowloon, Hong Kong.
Pediatr Surg Int. 2008 Jun;24(6):751-4. doi: 10.1007/s00383-008-2155-3. Epub 2008 Apr 12.
Actinomycosis is a rare disease in children and young adolescents and its thoracic manifestations accounted for a minority of all cases. We report a case of a 12-year-old boy who presented with a right anterior chest wall mass for one week together with weight loss and low grade fever for one month. His symptoms and signs as well as the results of the radiological investigations (i.e. chest X-ray and computed tomography (CT) of thorax with contrast) mimicked pulmonary tuberculosis or chest wall tumor. The definite diagnosis of actinomycosis relies on the Gram stain microscopy and culture of the chest wall lesion aspirates. An early and accurate diagnosis can prevent the patient from unnecessary invasive procedures such as open lung biopsy or thoracotomy. The mainstay of the treatment of actinomycosis remains to be a combination of abscess drainage as well as prolonged antibiotics such as penicillin. Follow-up CT scan of thorax with contrast is useful in monitoring the progress of disease recovery.
放线菌病在儿童和青少年中是一种罕见疾病，其胸部表现占所有病例的少数。我们报告一例12岁男孩，他右前胸壁肿物1周，伴体重减轻和低热1个月。他的症状、体征以及放射学检查结果（即胸部X线和胸部增强计算机断层扫描（CT））类似肺结核或胸壁肿瘤。放线菌病的确切诊断依赖于胸壁病变抽吸物的革兰氏染色显微镜检查和培养。早期准确诊断可避免患者接受不必要的侵入性操作，如开胸肺活检或开胸手术。放线菌病治疗的主要方法仍然是脓肿引流以及使用如青霉素等长时间的抗生素联合治疗。胸部增强CT随访扫描有助于监测疾病恢复进程。
