Nakamura Saya, Kusunose Masaaki, Satou Akira, Senda Kazuyoshi, Hasegawa Yoshinori, Nishimura Koichi
National Center for Geriatrics and Gerontology, Department of Pulmonary Medicine, 7-430, Morioka-cho, Obu, 474-8511, Japan.
Division of Respiratory Medicine, Department of Medicine, Nagoya University Graduate School of Medicine, 5 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan.
Respir Med Case Rep. 2017 Apr 13;21:118-120. doi: 10.1016/j.rmcr.2017.04.008. eCollection 2017.
A previously healthy 73-year-old man was hospitalized with left complicated effusion and a consolidation in the left upper lung. He underwent a chest tube insertion and was treated with clindamycin but the consolidation remained after the treatment. We subsequently performed flexible bronchoscopy but it was impossible to make a diagnosis. Three months later, the consolidation had worsened so we performed another bronchoscopy. Finally, we were able to diagnose the consolidation as pulmonary actinomycosis, and to treat the condition appropriately. Pulmonary actinomycosis is a rare and difficult condition to diagnose. There are many conditions with similar clinical features, such as tuberculosis, fungal infections, lung abscesses, and lung malignancy. Respiratory physicians should consider the possibility of pulmonary actinomycosis when investigating patients with persistent pulmonary infiltrations. Early diagnosis and correct treatment may lead to a good prognosis and prevent unnecessary surgery.
一名73岁既往健康的男性因左侧复杂性胸腔积液和左上肺实变入院。他接受了胸腔闭式引流术，并接受了克林霉素治疗，但治疗后实变仍存在。随后我们进行了可弯曲支气管镜检查，但无法做出诊断。三个月后，实变加重，于是我们又进行了一次支气管镜检查。最终，我们得以将实变诊断为肺放线菌病，并进行了恰当治疗。肺放线菌病是一种罕见且难以诊断的疾病。有许多疾病具有相似的临床特征，如肺结核、真菌感染、肺脓肿和肺部恶性肿瘤。呼吸内科医生在对持续性肺部浸润患者进行检查时应考虑肺放线菌病的可能性。早期诊断和正确治疗可能带来良好预后并避免不必要的手术。
