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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Actinomycosis is a chronic suppurative infection with filamentous, gram-positive, nonspore forming anaerobic bacteria of the genus Actinomyces. Actinomyces species are commensals of the human oropharynx, gastrointestinal tract, and female genitalia. Involvement of the thorax accounts for 15% to 20% of actinomycosis cases. Thoracic actinomycosis classically presents as an intrapulmonary infection of the alveoli, peribronchial tissue, and/or bronchioles. Endobronchial actinomycosis is a rare condition that has been reported in association with aspiration of a foreign body or broncholithiasis. A critical component in the pathogenesis is disruption of the mucosal barrier, thereby allowing invasion of the microorganisms from aspirated oropharyngeal secretions. Even with a high clinical suspicion, actinomycosis is a diagnostic challenge. The most common symptoms of endobronchial actinomycosis include cough, sputum production, and fever. The disease is often confused with lung cancer, tuberculosis, fungal infections, nocardiosis, and poorly responding pneumonia. The present case highlights the first reported case of endobronchial actinomycosis associated with a covered nitinol endobronchial stent.
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PMID:Endobronchial actinomycosis after airway stenting. 2320 33

While the most common presentation of actinomycosis is cervicofacial disease, or "lumpy jaw syndrome," Actinomyces meyeri has a predilection for pulmonary disease as well as dissemination to distant organs. We describe a 61-year-old Caucasian male with a relapsing-remitting mandibular sinus tract who would go on to develop weight loss, dyspnea, and a cough productive of malodorous sputum. Imaging revealed a right lower lobe pneumonia and a large left sided empyema. He underwent thoracotomy and decortication on the left side, and 1 L of foul-smelling purulent fluid was drained. Culture grew Actinomyces meyeri. He completed an extended antibiotic course and had his teeth extracted with good clinical outcome.
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PMID:Actinomyces meyeri: from "lumpy jaw" to empyema. 2353 75

We present a 70-year-old female patient who had the history of hypertension and presented with massive haemoptysis. She had been complaining of cough with expectoration and mild streaking of blood in sputum for about 3 days with only crepts in right infrascapular and infra-axillary regions as positive clinical findings. Bronchoscopy revealed a cauliflower-like lesion in the upper- right lobe bronchus; bronchial aspirate showed occasional colonies of gram positive filamentous bacteria surrounded by neutrophils. The Trucut biopsy showed sheets of neutrophils with colonies of filamentous bacteria consistent with actinomycotic infection. She was started on intravenous benzyl penicillin 20 million units 6 hourly. She recovered with no further bouts of hemoptysis and was discharged on amoxicillin + clavulanic acid in a stable condition and she remained under similar condition for more than a year on follow up. Actinomycosis is a rare disease caused by a harmless commensal species, Actinomyces. Diagnosis of actinomycosis is a challenging situation, and more so, very few cases causing hemoptysis have come to light so far.
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PMID:Hemoptysis secondary to actinomycosis: A rare presentation. 2477 85

This paper describes the case of a 75-year-old female who presented with significant hemoptysis over a 7-10 day period. She had a history of a left lower lobectomy 10 years prior for a "lung abscess." She subsequently had multiple episodes of cough, fevers, and possible pneumonia treated with multiple courses of Amoxicillin and Amoxicillin/Clavulanate. Review of her chest CT upon presentation to the hospital showed a large necrotic lingular infiltrate, which had been progressively increasing in size over at least one year. Bronchoscopy showed a yellowish, soft round body in the superior lingular subsegment. Endobronchial and transbronchial biopsies showed actinomyces species. This is a very interesting case of indolent actinomycosis which we suspect had a very slow progressive course secondary to the multiple courses of antibiotics that the patient was treated with.
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PMID:A 75-year-old female with hemoptysis and recurrent respiratory infections. 2482 30

Pulmonary actinomycosis is a rare disease that is often misdiagnosed as tuberculosis or lung cancer. Actinomyces graevenitzii is a relatively new recognized Actinomyces species isolated from various clinical samples. The authors report a case of pulmonary actinomycosis caused by A graevenitzii. A computed tomography examination revealed an excavated consolidation in the middle right lobe of a previously healthy young man who presented with a long history of moderate cough. Cultures of the bronchoalveolar lavage fluid confirmed the diagnosis of pulmonary abscess caused by A gravenitzii. At the three-month follow-up consultation and, after six weeks of high-dose amoxicillin, the pulmonary lesion had completely disappeared.
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PMID:Actinomyces graevenitzii pulmonary abscess mimicking tuberculosis in a healthy young man. 2549 91

The aspiration of foreign bodies may induce various infectious diseases, including actinomycosis, and its association with foreign bodies has been reported. We encountered a patient who developed Actinomyces-induced lung abscess associated with aspiration of cedar leaves. The patient was a 56-year-old Japanese woman who aspirated decorative cedar leaves contained in a lunch box while eating a meal, and coughing and bloody phlegm occurred thereafter. A mass was noted in the right lower lobe of the lung on plain chest computed tomography on the first consultation, and granules of Actinomyces were noted on transbronchial lung biopsy. Long-term antibiotic administration was performed, but no improvement was obtained. Thus, right lower lobectomy was performed. On postoperative pathologic examination, cedar leaves were present in the bronchus, bacterial colonies adhered to these, and there was surrounding inflammatory cell infiltration, mainly involving histiocytes and lymphocytes. This is the first report of Actinomyces associated with aspiration of cedar leaves. When the foreign body cannot be removed, it may be difficult to improve the condition by antibiotic administration alone, and surgery may be necessary.
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PMID:A Case of Pulmonary Actinomycosis Associated With Aspiration of Cedar Leaves. 2616 98

Pulmonary actinomycosis is a chronic, suppurative, granulomatous disease caused by Actinomyces israelii, an obligate anaerobe. The clinical manifestations and imaging characteristics of pulmonary actinomycosis lack specificity and can lead to confusion with tuberculosis and lung cancer. The present study reported a case of pulmonary actinomycosis diagnosed by transbronchoscopic lung biopsy and reviewed the literature on the disease. The clinical characteristics, signs, laboratory findings as well as progression, diagnosis and treatment in the case of pulmonary actinomycosis were analyzed. The patient was diagnosed by transbronchoscopic lung biopsy. After two weeks of antibiotic therapy, the cough was significantly improved and the patient's temperature returned to normal. Moreover, the lesion in the left lower lung was significantly smaller. Pulmonary actinomycosis is usually confused for tuberculosis and lung cancer. The present findings indicated that transbronchoscopic lung biopsy is a useful tool for diagnosing the disease. To conclude, doctors should have a clear enough understanding of the disease to prescribe empirical antibiotics and avoid unnecessary surgery.
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PMID:Pulmonary actinomycosis diagnosed by transbronchoscopic lung biopsy: A case report and literature review. 3018 88

Actinomyces naeslundii is a commensal flora of the oral cavity and is generally considered as an avirulent saprophytic bacterium in immunocompetent patients. It can become an opportunistic anaerobic pathogen in oral cavity in patients with poor oral hygiene or tooth extraction and can cause periodontal disease. Pulmonary Actinomycosis is a rare manifestation and may be suspected in middle-aged male patients with cough and hemoptysis showing radiological findings of a peripheral mass or chronic consolidation in whom repeated aerobic cultures have yielded negative results. Here, we report isolation of A. naeslundii from the bronchoalveolar lavage sample from an immunocompetent patient who presented with chronic nonresolving pneumonia of 6 months duration.
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PMID:Actinomyces naeslundii causing pulmonary endobronchial Actinomycosis - A case report. 3097 69

A 57-year-old male with schizophrenia and a 37 pack-year smoking history presented with cough productive of purulent sputum associated with hemoptysis and worsening shortness of breath. Computed tomography (CT) scan revealed multiple masses in the right upper and lower lobes with a small distal tracheal mass and significant mediastinal lymphadenopathy. CT guided biopsy of the largest lung mass in the right lower lobe confirmed a diagnosis of pulmonary actinomycosis. The patient received appropriate antibiotic therapy for four weeks, but his condition did not improve. A repeat CT scan showed worsening of the right lung consolidation with increasing occlusion of the trachea. Bronchoscopy was performed which revealed a friable necrotic mass occupying 70% of the tracheal lumen. Histopathology showed squamous cell carcinoma of the trachea likely of primary origin. Unfortunately, the patient was not a candidate for any surgical intervention or oncologic treatment, and he died few days later. This patient had a rare simultaneous presentation of both pulmonary actinomycosis and tracheal squamous cell carcinoma. To the best of our knowledge, this is the first reported case of simultaneous diagnosis of both conditions in the same patient. This case illustrates the importance of looking for an alternative diagnosis in patients with actinomycosis who do not respond well to appropriate therapy.
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PMID:Pulmonary actinomycosis and tracheal squamous cell carcinoma: A rare simultaneous presentation of both in a single patient. 3119 41

A 45-year-old- man presented with left chest wall pain, swelling and cough. Over a 2-month period he developed abscesses in the right foot, right anterior thigh, left buttock and left chest. Incision and drainage of the soft tissue abscesses and video-assisted thoracoscopic surgery to drain the loculated empyema contiguous with the chest wall abscess were performed as surgical management. Gram stain showed beaded Gram-positive rods and the culture initially grew Aggregatibacter actinomycetemcomitans and Eikenella corrodens Pathological evaluation of the pleura showed sulfur granules and organisms consistent with Actinomyces spp. on Gomori methenamine silver stain; Actinomyces israelii was recovered in culture with extended incubation. The patient was treated for 3 weeks with ceftriaxone and oral metronidazole, followed by oral amoxicillin. Culture of A. actinomycetemcomitans with other findings consistent with actinomycosis warrants 6-12 months of antibiotic therapy.
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PMID:Mixed Actinomyces israelii and Aggregatibacter actinomycetemcomitans infection causing empyema necessitatis and multiple skin abscesses in an immunocompetent patient. 3155 18


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