Kinnear W J, MacFarlane J T
City Hospital, Nottingham, U.K.
Respir Med. 1990 Jan;84(1):57-9. doi: 10.1016/s0954-6111(08)80095-9.
We have reviewed the case notes of 19 patients with thoracic actinomycosis. The median age at presentation was 42 (range 9-66) years, 15 were male and 12 were urban residents. Cough, sputum production, chest pain and weight loss were the commonest symptoms. Six patients reported haemoptysis. In contrast with the classical appearances of thoracic actinomycosis, only four patients had cutaneous abnormalities, and only one patient had radiological evidence of bone involvement. The provisional diagnosis was bronchial carcinoma in nine patients, and in seven patients the diagnosis of actinomycosis was only made after resection of the lesion, in two cases by pneumonectomy. The median delay between presentation and diagnosis was 3.5 (range 1-24) weeks. Two patients developed extrathoracic complications, but all patients made a full recovery after receiving antibiotic therapy for a median of 6 (range 1-24) weeks. Thoracic actinomycosis is rare, but should still be considered in the differential diagnosis of a pulmonary lesion thought to be malignant.
我们回顾了19例胸段放线菌病患者的病例记录。就诊时的中位年龄为42岁（范围9 - 66岁），15例为男性，12例为城市居民。咳嗽、咳痰、胸痛和体重减轻是最常见的症状。6例患者报告有咯血。与胸段放线菌病的典型表现不同，只有4例患者有皮肤异常，只有1例患者有骨受累的影像学证据。9例患者的初步诊断为支气管癌，7例患者仅在病变切除后才诊断为放线菌病，2例通过肺切除术。从就诊到诊断的中位延迟时间为3.5周（范围1 - 24周）。2例患者出现胸外并发症，但所有患者在接受中位时间为6周（范围1 - 24周）的抗生素治疗后均完全康复。胸段放线菌病很少见，但在疑似恶性肺病变的鉴别诊断中仍应予以考虑。
