Charif F, Harb A, Alifano M, Giraud F, Rabbat A, Huchon G, Roche N
Service de Pneumologie et Réanimation, Hôtel-Dieu, Paris, France.
Rev Mal Respir. 2009 Nov;26(9):1003-6. doi: 10.1016/s0761-8425(09)73338-8.
A 60 year old male patient was admitted to hospital with pulmonary and cerebral abscesses. A percutaneous lung biopsy under CT scanning showed actinomycosis. After 4 weeks antibiotic therapy with ceftriaxone and metronidazole there was an improvement in the pulmonary lesion but new cerebral lesions appeared. A neurosurgical cerebral biopsy showed evidence of metastatic squamous carcinoma, probably of pulmonary origin. The diagnosis had been delayed by the presence of the actinomycosis. His general condition did not permit anti-tumour treatment and the patient soon afterwards. In the presence of pulmonary actinomycosis an associated malignancy should be excluded.
一名60岁男性患者因肺脓肿和脑脓肿入院。CT扫描引导下经皮肺活检显示为放线菌病。使用头孢曲松和甲硝唑进行4周抗生素治疗后,肺部病变有所改善,但出现了新的脑部病变。神经外科脑活检显示有转移性鳞状细胞癌的证据,可能起源于肺部。放线菌病的存在导致了诊断延误。患者的一般状况不允许进行抗肿瘤治疗,此后不久患者死亡。在存在肺放线菌病的情况下,应排除相关的恶性肿瘤。