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21 世纪第一个十年中的肺部放线菌病:94 例患者的病例。

Pulmonary actinomycosis during the first decade of 21st century: cases of 94 patients.

出版信息

BMC Infect Dis. 2013 May 14;13:216. doi: 10.1186/1471-2334-13-216.

DOI:10.1186/1471-2334-13-216
PMID:23672372
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3658925/
Abstract

BACKGROUND

Pulmonary actinomycosis is a chronic pulmonary infection caused by Actinomyces. Both improving oral hygiene and early application of antibiotics to the case of suspicious pulmonary infections result in changes in incidences and presentations of pulmonary actinomycosis. However, there are little reports dealt with the recent clinical characteristics of pulmonary actinomycosis. This study aimed to review the characteristics of pulmonary actinomycosis occurred during the first decade of 21st century.

METHODS

This retrospective study was performed on 94 subjects with pulmonary actinomycosis diagnosed pathologically from January 2000 to December 2010 in 13 hospitals in Korea.

RESULTS

The data of the study showed that pulmonary actinomycosis occurs frequently in middle to old-aged males (mean age; 57.7 years old) and that the most common symptoms are cough, hemoptysis, and sputum production. Various radiologic features such as the consolidation with central low attenuation (74.5%) and no regional predominance were also observed. Most of patients recovered completely with medical and/or surgical treatment, reaching approximately 98% cure rate.

CONCLUSIONS

The results demonstrate that pulmonary actinomycosis is one of the cautious pulmonary diseases. More importantly, in cases of persistent hemoptysis or for differential diagnosis from lung malignancy, our data have revealed that surgical resection appears to be a useful intervention and that radiologic diagnosis may not provide decisive information. These findings indicate that it is important for the clinicians to include pulmonary actinomycosis as one of differential diagnoses for refractory pulmonary abnormal lesions to the current usual management.

摘要

背景

肺放线菌病是一种由放线菌引起的慢性肺部感染。改善口腔卫生和对疑似肺部感染病例及早应用抗生素,导致肺放线菌病的发病率和表现发生变化。然而,很少有报道涉及肺放线菌病的近期临床特征。本研究旨在回顾 21 世纪第一个十年期间肺放线菌病的特征。

方法

本回顾性研究对韩国 13 家医院 2000 年 1 月至 2010 年 12 月期间经病理诊断为肺放线菌病的 94 例患者进行了研究。

结果

研究数据显示,肺放线菌病常发生于中老年男性(平均年龄 57.7 岁),最常见的症状是咳嗽、咯血和咳痰。还观察到各种影像学特征,如伴有中央低衰减的实变(74.5%)和无区域性优势。大多数患者通过药物和/或手术治疗完全康复,治愈率约为 98%。

结论

结果表明,肺放线菌病是一种需要慎重考虑的肺部疾病。更重要的是,对于持续性咯血或需要与肺部恶性肿瘤进行鉴别诊断的病例,我们的数据表明,手术切除似乎是一种有用的干预措施,影像学诊断可能无法提供决定性信息。这些发现表明,对于当前常规管理中难治性肺部异常病变,临床医生将肺放线菌病纳入鉴别诊断之一非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/987f/3658925/733b1142137c/1471-2334-13-216-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/987f/3658925/aeda53fecc67/1471-2334-13-216-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/987f/3658925/733b1142137c/1471-2334-13-216-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/987f/3658925/aeda53fecc67/1471-2334-13-216-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/987f/3658925/733b1142137c/1471-2334-13-216-2.jpg

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