Thrun Connor S, Boster Joshua, Jansen Nathan, Dado David, Okulicz Jason
Internal Medicine, Brooke Army Medical Center, Fort Sam Houston, San Antonio, USA.
Infectious Disease, Brooke Army Medical Center, Fort Sam Houston, San Antonio, USA.
Cureus. 2020 Jun 3;12(6):e8423. doi: 10.7759/cureus.8423.
Actinomycosis is an uncommon bacterial infection that presents as an indolent, progressive disease that can affect multiple organ systems. We describe the case of a 66-year-old female with end-stage renal disease who presented to the emergency department after developing acute dyspnea and chest pain two weeks after undergoing a diagnostic esophagogastroduodenoscopy (EGD). A CT scan was obtained that revealed a large mediastinal mass, which was initially concerning for a potential malignancy. Biopsy of the mass and Gram stain was consistent with mediastinal actinomycosis. The patient was subsequently treated with an extended course of antibiotics that resulted in significant clinical improvement. Previously reported cases describing a correlation between EGD and mediastinal actinomycosis have been associated with invasive procedures such as esophageal stent placement and transesophageal biopsy. We describe a case of an uncommon infectious complication of a diagnostic EGD that was not associated with intentional mucosal disruption.
放线菌病是一种罕见的细菌感染，表现为一种进展缓慢的慢性疾病，可累及多个器官系统。我们描述了一例66岁终末期肾病女性患者的病例，该患者在接受诊断性食管胃十二指肠镜检查（EGD）两周后出现急性呼吸困难和胸痛，随后前往急诊科就诊。进行了CT扫描，结果显示一个巨大的纵隔肿块，最初怀疑可能是恶性肿瘤。对肿块进行活检及革兰氏染色，结果与纵隔放线菌病相符。该患者随后接受了较长疗程的抗生素治疗，临床症状有显著改善。先前报道的描述EGD与纵隔放线菌病之间相关性的病例均与诸如食管支架置入和经食管活检等侵入性操作有关。我们描述了一例诊断性EGD罕见的感染性并发症病例，该病例与故意的黏膜破坏无关。
