Disseminated pulmonary actinomycosis with hepatic injury: a misleading form mimicking a polymetastatic picture

Thoracic actinomycosis, caused by bacteria of the Actinomyces genus, is a rare infection, with poor prognosis if untreated, whose clinical and radiological picture is misleading, which can simulate a tumoral or tuberculous disease. This is a case of generalised pseudotumoral pulmonary actinomycosis...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Revue de pneumologie clinique Jg. 68; H. 1; S. 40
Hauptverfasser: Rakotoson, J L, Andrianasolo, R, Rakotomizao, J R, Rakotoharivelo, H, Andrianarisoa, A C F
Format: Journal Article
Sprache:Französisch
Veröffentlicht: France 01.02.2012
Schlagworte:
ISSN:0761-8417, 1776-2561, 1776-2561
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Abstract Thoracic actinomycosis, caused by bacteria of the Actinomyces genus, is a rare infection, with poor prognosis if untreated, whose clinical and radiological picture is misleading, which can simulate a tumoral or tuberculous disease. This is a case of generalised pseudotumoral pulmonary actinomycosis in a non-smoking, non-drinking 48-year-old man, who for one month has been presenting a cough with haemoptoic sputum, dyspnoea associated with fever and a deterioration in general condition. The clinical examination discovered weight loss, diffuse crackling rales and multiple dental caries. Biologically, he presented an inflammatory syndrome. The radiological imaging and lung and liver CT-scans discovered a peripheral lung mass right side associated with multiple nodular cannon-ball opacities, multiple liver lesions of metastatic appearance. The bacteriological examination of the bronchoalveolar lavage fluid (Gram stain and culture) and the transparietal biopsy of the lung mass confirmed the presence of Actinomyces. Progress under treatment with 10 million international units of parenteral penicillin G daily over a period of six weeks substituted by three grams of amoxicillin/clavulanic acid daily over a period of 12 months and following an oral preparatory procedure was favourable. The thoraco-abdominal scan carried out three months after the treatment showed that the lesions had completely disappeared. Our case illustrates the diagnostic difficulty of actinomycosis particularly faced with a picture of multiple lung and liver metastasis. Hence, the importance of a histological and bacteriological examination of samples. The prognosis of this complaint is generally good following well-managed, prolonged treatment; and the prognosis peculiar to disseminated forms is less certain.
AbstractList Thoracic actinomycosis, caused by bacteria of the Actinomyces genus, is a rare infection, with poor prognosis if untreated, whose clinical and radiological picture is misleading, which can simulate a tumoral or tuberculous disease. This is a case of generalised pseudotumoral pulmonary actinomycosis in a non-smoking, non-drinking 48-year-old man, who for one month has been presenting a cough with haemoptoic sputum, dyspnoea associated with fever and a deterioration in general condition. The clinical examination discovered weight loss, diffuse crackling rales and multiple dental caries. Biologically, he presented an inflammatory syndrome. The radiological imaging and lung and liver CT-scans discovered a peripheral lung mass right side associated with multiple nodular cannon-ball opacities, multiple liver lesions of metastatic appearance. The bacteriological examination of the bronchoalveolar lavage fluid (Gram stain and culture) and the transparietal biopsy of the lung mass confirmed the presence of Actinomyces. Progress under treatment with 10 million international units of parenteral penicillin G daily over a period of six weeks substituted by three grams of amoxicillin/clavulanic acid daily over a period of 12 months and following an oral preparatory procedure was favourable. The thoraco-abdominal scan carried out three months after the treatment showed that the lesions had completely disappeared. Our case illustrates the diagnostic difficulty of actinomycosis particularly faced with a picture of multiple lung and liver metastasis. Hence, the importance of a histological and bacteriological examination of samples. The prognosis of this complaint is generally good following well-managed, prolonged treatment; and the prognosis peculiar to disseminated forms is less certain.
Thoracic actinomycosis, caused by bacteria of the Actinomyces genus, is a rare infection, with poor prognosis if untreated, whose clinical and radiological picture is misleading, which can simulate a tumoral or tuberculous disease.INTRODUCTIONThoracic actinomycosis, caused by bacteria of the Actinomyces genus, is a rare infection, with poor prognosis if untreated, whose clinical and radiological picture is misleading, which can simulate a tumoral or tuberculous disease.This is a case of generalised pseudotumoral pulmonary actinomycosis in a non-smoking, non-drinking 48-year-old man, who for one month has been presenting a cough with haemoptoic sputum, dyspnoea associated with fever and a deterioration in general condition. The clinical examination discovered weight loss, diffuse crackling rales and multiple dental caries. Biologically, he presented an inflammatory syndrome. The radiological imaging and lung and liver CT-scans discovered a peripheral lung mass right side associated with multiple nodular cannon-ball opacities, multiple liver lesions of metastatic appearance. The bacteriological examination of the bronchoalveolar lavage fluid (Gram stain and culture) and the transparietal biopsy of the lung mass confirmed the presence of Actinomyces. Progress under treatment with 10 million international units of parenteral penicillin G daily over a period of six weeks substituted by three grams of amoxicillin/clavulanic acid daily over a period of 12 months and following an oral preparatory procedure was favourable. The thoraco-abdominal scan carried out three months after the treatment showed that the lesions had completely disappeared.CLINICAL CASEThis is a case of generalised pseudotumoral pulmonary actinomycosis in a non-smoking, non-drinking 48-year-old man, who for one month has been presenting a cough with haemoptoic sputum, dyspnoea associated with fever and a deterioration in general condition. The clinical examination discovered weight loss, diffuse crackling rales and multiple dental caries. Biologically, he presented an inflammatory syndrome. The radiological imaging and lung and liver CT-scans discovered a peripheral lung mass right side associated with multiple nodular cannon-ball opacities, multiple liver lesions of metastatic appearance. The bacteriological examination of the bronchoalveolar lavage fluid (Gram stain and culture) and the transparietal biopsy of the lung mass confirmed the presence of Actinomyces. Progress under treatment with 10 million international units of parenteral penicillin G daily over a period of six weeks substituted by three grams of amoxicillin/clavulanic acid daily over a period of 12 months and following an oral preparatory procedure was favourable. The thoraco-abdominal scan carried out three months after the treatment showed that the lesions had completely disappeared.Our case illustrates the diagnostic difficulty of actinomycosis particularly faced with a picture of multiple lung and liver metastasis. Hence, the importance of a histological and bacteriological examination of samples. The prognosis of this complaint is generally good following well-managed, prolonged treatment; and the prognosis peculiar to disseminated forms is less certain.CONCLUSIONOur case illustrates the diagnostic difficulty of actinomycosis particularly faced with a picture of multiple lung and liver metastasis. Hence, the importance of a histological and bacteriological examination of samples. The prognosis of this complaint is generally good following well-managed, prolonged treatment; and the prognosis peculiar to disseminated forms is less certain.
Author Andrianasolo, R
Rakotomizao, J R
Andrianarisoa, A C F
Rakotoson, J L
Rakotoharivelo, H
Author_xml – sequence: 1
  givenname: J L
  surname: Rakotoson
  fullname: Rakotoson, J L
  email: jrakotoson@yahoo.fr
  organization: Unité de soins de formations et de recherche (USFR) de pneumologie, CHU d'Antananarivo, Antananarivo, Madagascar. jrakotoson@yahoo.fr
– sequence: 2
  givenname: R
  surname: Andrianasolo
  fullname: Andrianasolo, R
– sequence: 3
  givenname: J R
  surname: Rakotomizao
  fullname: Rakotomizao, J R
– sequence: 4
  givenname: H
  surname: Rakotoharivelo
  fullname: Rakotoharivelo, H
– sequence: 5
  givenname: A C F
  surname: Andrianarisoa
  fullname: Andrianarisoa, A C F
BackLink https://www.ncbi.nlm.nih.gov/pubmed/22305136$$D View this record in MEDLINE/PubMed
BookMark eNo1kFtLAzEQhYNU7EX_gUjefNo6k90mW9-kXqHgiz6XbJK1qZtk3WSR_nu3WmHgcODMYeabkpEP3hByiTBHQH6zm7fe9C7MGSDOYRgoT8gEheAZW3AckQkIjllZoBiTaYw7AIYC8IyMGcthgTmfEH9vYzTOepmMpm3fuOBlt6dSJeuD26sQbaTfNm3p1rQyWUWt3_Xd_pZK6mxsjNTWf9A6dG7wzqrPg5W0Dc3emSRj-l1qrUp9Z87JaS2baC6OOiPvjw9vq-ds_fr0srpbZy0WkDJV8koYzFFzKXQ1_KRxaTjUCgqmaq6gypnWqgaVC1GUQoFY8rosF1JppVg-I9d_vW0XvnoT02a4VZmmkd6EPm6WDAYEmB-SV8dkXzmjN21n3QBg848o_wE_SG9h
ContentType Journal Article
Copyright Copyright © 2011 Elsevier Masson SAS. All rights reserved.
Copyright_xml – notice: Copyright © 2011 Elsevier Masson SAS. All rights reserved.
DBID CGR
CUY
CVF
ECM
EIF
NPM
7X8
DOI 10.1016/j.pneumo.2011.01.008
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
MEDLINE - Academic
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
MEDLINE - Academic
DatabaseTitleList MEDLINE
MEDLINE - Academic
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: 7X8
  name: MEDLINE - Academic
  url: https://search.proquest.com/medline
  sourceTypes: Aggregation Database
DeliveryMethod fulltext_linktorsrc
DocumentTitleAlternate Actinomycose pulmonaire disséminée avec atteinte hépatique: une forme trompeuse mimant un tableau polymétastatique
EISSN 1776-2561
ExternalDocumentID 22305136
Genre Journal Article
Case Reports
GroupedDBID .GJ
08J
08T
0R~
123
4.4
457
53G
AAEDT
AAEDW
AALRI
AATTM
AAXKI
AAXUO
ABJNI
ACRLP
AEBSH
AEIPS
AENEX
AFNOS
AFTJW
AFXIZ
AIEXJ
AIKHN
AITUG
AKRWK
ALMA_UNASSIGNED_HOLDINGS
AMRAJ
ANKPU
AOOFG
AXJTR
BKOJK
CGR
CS3
CUY
CVF
DU5
EBS
ECM
EFJIC
EIF
EJD
F5P
FDB
FYGXN
HZ~
KOM
NPM
O9-
RIG
SEM
SES
SSH
T5K
7X8
ID FETCH-LOGICAL-p140t-c86b7e131d6a7db177d19e60fc042cf6c0b32ddcf0c377487c0796f885acdcc23
ISICitedReferencesCount 3
ISICitedReferencesURI http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000301029700008&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN 0761-8417
1776-2561
IngestDate Thu Jul 10 21:11:47 EDT 2025
Thu Apr 03 07:01:00 EDT 2025
IsPeerReviewed false
IsScholarly false
Issue 1
Language French
License Copyright © 2011 Elsevier Masson SAS. All rights reserved.
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-p140t-c86b7e131d6a7db177d19e60fc042cf6c0b32ddcf0c377487c0796f885acdcc23
Notes ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
PMID 22305136
PQID 920230132
PQPubID 23479
ParticipantIDs proquest_miscellaneous_920230132
pubmed_primary_22305136
PublicationCentury 2000
PublicationDate 2012-Feb
20120201
PublicationDateYYYYMMDD 2012-02-01
PublicationDate_xml – month: 02
  year: 2012
  text: 2012-Feb
PublicationDecade 2010
PublicationPlace France
PublicationPlace_xml – name: France
PublicationTitle Revue de pneumologie clinique
PublicationTitleAlternate Rev Pneumol Clin
PublicationYear 2012
SSID ssj0021701
Score 1.5137459
Snippet Thoracic actinomycosis, caused by bacteria of the Actinomyces genus, is a rare infection, with poor prognosis if untreated, whose clinical and radiological...
SourceID proquest
pubmed
SourceType Aggregation Database
Index Database
StartPage 40
SubjectTerms Actinomycosis - diagnosis
Actinomycosis - diagnostic imaging
Actinomycosis - drug therapy
Bronchoalveolar Lavage
Humans
Liver - diagnostic imaging
Liver - pathology
Lung - diagnostic imaging
Lung - microbiology
Lung - pathology
Lung Diseases, Fungal - diagnosis
Lung Diseases, Fungal - drug therapy
Male
Middle Aged
Penicillin G - therapeutic use
Tomography, X-Ray Computed
Title Disseminated pulmonary actinomycosis with hepatic injury: a misleading form mimicking a polymetastatic picture
URI https://www.ncbi.nlm.nih.gov/pubmed/22305136
https://www.proquest.com/docview/920230132
Volume 68
WOSCitedRecordID wos000301029700008&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
journalDatabaseRights – providerCode: PRVESC
  databaseName: ScienceDirect Freedom Collection - Elsevier
  customDbUrl:
  eissn: 1776-2561
  dateEnd: 20181231
  omitProxy: false
  ssIdentifier: ssj0021701
  issn: 0761-8417
  databaseCode: AIEXJ
  dateStart: 20040601
  isFulltext: true
  titleUrlDefault: https://www.sciencedirect.com
  providerName: Elsevier
link http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV1LT9wwELYW6KGXiqovSkE-9IZS5bW2ww0VUMsBVRWV9rby2o4IbB5akhXtP-m_7YztZFlWSO2hl2g33iRez6fJjD3fZ0I-ijTO-dhAdhJxAwmKZoFMOQtibYSEpFlKo-xmE_zyUkwm2bfR6HfPhVnOeVWJ-_us-a-mhnNgbKTO_oO5h5vCCfgMRocjmB2Of2X4U1xhxwIXjCWbbg4Pxso4JDAgf0HVKEFip1-vTWP1WovqBlfTLe0ZzD53dfWW1wjfy0LdWiYjbujwszStRBISXNYUqtcj6cPb72bZIRHrqKlMV1q_ahz50tV2-yWl27qtPdPr4miYfcbaSgCrhOGp10oZ3QVl8Uu6ZaLHLdeQ72Pp04pr4acxsB5kKAlx3o6zKBCpI3L2rpmJDQg6P-sknjbcv5uJuPnk_qQXaI1Qwvbhz2E8m9JaH2IjcErJIy1u-3bvm7bITszHGTjMnZOvZ5OLIZtHIXur8er73fMybfHgZgdQddrf8ulkxgY1V7vkhc9G6IlD0UsyyhevSPUQQXRAEF1DEEUEUY8g6hB0TCVd4YcifuiAH2hbxw_1-HlNfpyfXX3-EvhtOYIGsvE2UILNuImSSDPJNcqX6SgzLMwVvABUzlQ4S2KtVR6qBJILwVXIM5YLMZZKKxUnb8h2VVfmHaFMGi0kRMh5qtJQzsA35EzOdMaMirTge4T2IzWF_uNalqxM3d1NsxiT5yiJ98hbN4LTxsmzTPthfv9kyz55voLgB7LdLjpzQJ6pZVvcLQ7JFp-IQ2_uP8u6hNQ
linkProvider Elsevier
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Disseminated+pulmonary+actinomycosis+with+hepatic+injury%3A+a+misleading+form+mimicking+a+polymetastatic+picture&rft.jtitle=Revue+de+pneumologie+clinique&rft.au=Rakotoson%2C+J+L&rft.au=Andrianasolo%2C+R&rft.au=Rakotomizao%2C+J+R&rft.au=Rakotoharivelo%2C+H&rft.date=2012-02-01&rft.issn=0761-8417&rft.volume=68&rft.issue=1&rft.spage=40&rft_id=info:doi/10.1016%2Fj.pneumo.2011.01.008&rft_id=info%3Apmid%2F22305136&rft.externalDocID=22305136
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0761-8417&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0761-8417&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0761-8417&client=summon