Golfi Nicoletta, Mastriforti Roberta, Guidelli Luca, Scala Raffaele
Pulmonology and RICU, S Donato Hospital, Arezzo, Italy.
Internal Medicine, S Sepolcro Hospital, Arezzo, Italy.
BMC Infect Dis. 2021 May 8;21(1):433. doi: 10.1186/s12879-021-06126-3.
Primary endobronchial actinomycosis is exceptionally uncommon and can be misdiagnosed as unresolving pneumonia, endobronchial lipoma, bronchogenic carcinoma or foreign body. Predisposing factors are immunosuppressive conditions, chronic lung diseases, poor oral hygiene or foreign body aspiration.
We reported a case of 88-year old woman with a 4 days history of mild exertional dyspnea, productive cough with purulent sputum and fever up to 37.8 °C, who developed left sided endobronchial actinomycosis in absence of any pre-existent risk conditions; endobronchial de-obstruction and specific antibiotic treatment were performed with success, achieving a full resolution of the disease, with bronchoscopy playing a key role in the diagnosticand therapeutic pathways.
This case raises the necessity for increased awareness in the management of endobronchial lesions and in cases of suspected endobronchial actinomycosis; bronchoscopy plays a key role in the diagnostic and therapeutic process; prompt recognition of this entity can expedite proper treatment and recovery.
原发性支气管放线菌病极为罕见，可能被误诊为迁延不愈的肺炎、支气管内脂肪瘤、支气管癌或异物。诱发因素包括免疫抑制状态、慢性肺部疾病、口腔卫生差或异物吸入。
我们报告了一例88岁女性病例，患者有4天轻度劳力性呼吸困难、咳脓性痰的咳嗽及体温高达37.8°C发热的病史，在无任何既往风险因素的情况下发生了左侧支气管放线菌病；进行了支气管内解除梗阻及特异性抗生素治疗，成功治愈疾病，支气管镜检查在诊断和治疗过程中发挥了关键作用。
该病例凸显了提高对支气管内病变及疑似支气管放线菌病病例管理认识的必要性；支气管镜检查在诊断和治疗过程中起关键作用；及时识别该疾病可加快恰当治疗及康复。
