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[儿童肺部放线菌病合并胸壁瘘管形成]

[Pulmonary actinomycosis with chest wall fistula formation in a child].

作者信息

Aharmim M, Kouismi H, Marc K, Soualhi M, Zahraoui R, Benamor J, Bourkadi J-D, Iraqi G

机构信息

Service de pneumo-phtisiologie, hôpital Moulay Youssef, faculté de médecine et de pharmacie, université Med V Souissi, Rabat, Maroc.

Service de pneumo-phtisiologie, hôpital Moulay Youssef, faculté de médecine et de pharmacie, université Med V Souissi, Rabat, Maroc.

出版信息

Arch Pediatr. 2014 Jul;21(7):757-60. doi: 10.1016/j.arcped.2014.04.013. Epub 2014 Jun 13.

Abstract

INTRODUCTION

Actinomycosis is a suppurative infection caused by bacteria of the Actinomyces genus. It is a rare cause of pulmonary infection and can be difficult to diagnose because its presentation may mimic tuberculosis or cancer. In the absence of treatment of pulmonary lesions fistulae can develop. We report a case of thoracic actinomycosis with chest wall involvement in a child, managed in the pediatric department at Moulay Youssef University Hospital in Rabat, Morocco.

CASE REPORT

We report the case of a 13-year-old boy with a history of trauma to the right chest 1 year earlier, admitted with right-sided chest wall swelling with cutaneous fistulae. Physical examination identified a parietal mass with fistulization to the skin. Laboratory tests showed an inflammatory syndrome. The chest x-ray revealed moderate right pleural effusion. The thoracic computed tomography scan showed a right parietal pleural mass and the percutaneous biopsy confirmed the diagnosis of actinomycosis. The patient underwent antibiotic therapy with favorable evolution.

CONCLUSION

The diagnosis, the clinical, radiological and histological pattern, and the therapeutic features are described in this report.

摘要

引言

放线菌病是由放线菌属细菌引起的化脓性感染。它是肺部感染的罕见病因,且可能难以诊断,因为其表现可能类似肺结核或癌症。若肺部病变未得到治疗,可能会形成瘘管。我们报告一例摩洛哥拉巴特穆莱·优素福大学医院儿科收治的累及胸壁的儿童胸段放线菌病病例。

病例报告

我们报告一例13岁男孩,1年前有右胸外伤史,因右侧胸壁肿胀伴皮肤瘘管入院。体格检查发现一个与皮肤有瘘管相通的壁层肿物。实验室检查显示有炎症综合征。胸部X线显示右侧中等量胸腔积液。胸部计算机断层扫描显示右侧壁层胸膜肿物,经皮活检确诊为放线菌病。患者接受抗生素治疗,病情好转。

结论

本报告描述了该病的诊断、临床、影像学和组织学表现以及治疗特点。

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