Dontfraid F, Ramphal R
Department of Medicine, University of Florida College of Medicine, Gainesville 32610-0277.
Clin Infect Dis. 1994 Jul;19(1):143-5. doi: 10.1093/clinids/19.1.143.
The most common infectious cause of bilateral upper-lobe pulmonary disease is tuberculosis. However, we recently encountered a patient with bilateral apical infiltrates and multiple soft-tissue abscesses caused by Actinomyces odontolyticus. Other findings included fever, weight loss, and leukocytosis, and the patient's only known source of immunosuppression was a long history of alcoholism. There was no history of diabetes, steroid use, or other chronic underlying disease. The diagnosis was made by culture of drainage fluid from one abscess. Therapy with intravenous penicillin G led to rapid clinical improvement and reduction in the infiltrates. To our knowledge, the presentation of pulmonary infection, with bilateral apical infiltrates due to A. odontolyticus has not been previously reported in the medical literature.
双侧上叶肺部疾病最常见的感染原因是肺结核。然而，我们最近遇到了一名患者，其双侧肺尖浸润及多处软组织脓肿由溶齿放线菌引起。其他表现包括发热、体重减轻和白细胞增多，且该患者唯一已知的免疫抑制源是长期酗酒史。患者无糖尿病、使用类固醇或其他慢性基础疾病史。通过对一处脓肿引流液进行培养做出了诊断。静脉注射青霉素G治疗使临床症状迅速改善，浸润灶减少。据我们所知，医学文献中此前尚未报道过由溶齿放线菌引起的伴有双侧肺尖浸润的肺部感染表现。
