Wang Lingwei, Zhang Heng, Wu Di, Feng Mengjie, Yang Peng, Hu Xiaoyi, Tattevin Pierre, Hong Goohyeon, Chen Rongchang, Qiu Chen
Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, Shenzhen Institute of Respiratory Diseases, Shenzhen Key Laboratory of Respiratory Diseases, Shenzhen Key Laboratory of Pathogenic Microorganisms and Bacterial Resistance, First Affiliated Hospital of Southern Science and Technology University, Second Clinical Medical College of Jinan University, Shenzhen 518020, China.
Infectious Diseases and ICU, Pontchaillou University Hospital, 35033 Rennes cedex, France.
Ann Transl Med. 2019 Dec;7(23):793. doi: 10.21037/atm.2019.12.38.
Pulmonary actinomycosis (PA) is a rare subacute or chronic infectious disease. As simple culture of Actinomyces in BAL, as with sputum, may represent colonization, the diagnosis of PA relies on pathological examination. The preferred treatment is long-term, high-dose penicillin. A 6-12-month-course of antibacterial treatment is the rule in extended PA, although the optimal duration of treatment has not been investigated through randomized trial. In this article, we report a case presented with slowly-progressing pulmonary cavitary lesions. Actinomyces odontolyticus was detected in sputum specimen harvested by tracheoscopy. The clinical diagnosis was PA, which gradually improved with prolonged treatment of penicillin and ornidazole. This is followed by a discussion of diagnosis and treatment, especially in terms of treatment.
肺放线菌病（PA）是一种罕见的亚急性或慢性感染性疾病。由于在支气管肺泡灌洗（BAL）液中培养放线菌，如同在痰液中培养一样，可能仅代表定植，因此PA的诊断依赖于病理检查。首选治疗方法是长期、大剂量使用青霉素。对于播散性PA，通常采用6 - 12个月疗程的抗菌治疗，尽管尚未通过随机试验研究最佳治疗时长。在本文中，我们报告了一例表现为缓慢进展的肺空洞性病变的病例。通过气管镜检查采集的痰液标本中检测到溶齿放线菌。临床诊断为PA，经青霉素和奥硝唑延长治疗后病情逐渐改善。随后对诊断和治疗进行了讨论，尤其侧重于治疗方面。
