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Open Access Highly Accessed Research article

Pulmonary actinomycosis during the first decade of 21st century: cases of 94 patients

So Ri Kim12, Lae Young Jung12, In-Jae Oh3, Young-Chul Kim3, Kyeong-Cheol Shin4, Min Ki Lee5, Sei-Hoon Yang6, Hee Sun Park7, Mi-Kyung Kim8, Jin Young Kwak9, Soo-Jung Um10, Seung Won Ra11, Woo Jin Kim12, Seungsoo Kim13, Eu-Gene Choi14 and Yong Chul Lee12*

Author Affiliations

1 Department of Internal Medicine and Research Center for Pulmonary Disorders, Chonbuk National University Medical School, San 2-20, Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk, 561-180, Korea

2 Department of Internal Medicine and Research Center for Pulmonary Disorders, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, San 2-20, Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk, 561-180, Korea

3 Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea

4 Department of Internal Medicine, Yeungnam University College of Medicine and Regional Center for Respiratory Disease, Yeungnam University Medical Center, Daegu, Korea

5 Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea

6 Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, School of Medicine, Wonkwang University, Iksan, Korea

7 Department of Internal Medicine, Chungnam National University Medical School, Daejeon, Korea

8 Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea

9 Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea

10 Department of Internal Medicine, Division of Respiratory Medicine, Dong-A University, College of Medicine, Busan, Korea

11 Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea

12 Department of Internal Medicine, Kangwon National Univsersity School of Medicine, Chuncheon, Korea

13 Department of Internal Medicine, College of Medicine, Division of Pulmonology, The Catholic University of Korea, Seoul, Korea

14 Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea

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BMC Infectious Diseases 2013, 13:216  doi:10.1186/1471-2334-13-216

Published: 14 May 2013

Abstract

Background

Pulmonary actinomycosis is a chronic pulmonary infection caused by Actinomyces. Both improving oral hygiene and early application of antibiotics to the case of suspicious pulmonary infections result in changes in incidences and presentations of pulmonary actinomycosis. However, there are little reports dealt with the recent clinical characteristics of pulmonary actinomycosis. This study aimed to review the characteristics of pulmonary actinomycosis occurred during the first decade of 21st century.

Methods

This retrospective study was performed on 94 subjects with pulmonary actinomycosis diagnosed pathologically from January 2000 to December 2010 in 13 hospitals in Korea.

Results

The data of the study showed that pulmonary actinomycosis occurs frequently in middle to old-aged males (mean age; 57.7 years old) and that the most common symptoms are cough, hemoptysis, and sputum production. Various radiologic features such as the consolidation with central low attenuation (74.5%) and no regional predominance were also observed. Most of patients recovered completely with medical and/or surgical treatment, reaching approximately 98% cure rate.

Conclusions

The results demonstrate that pulmonary actinomycosis is one of the cautious pulmonary diseases. More importantly, in cases of persistent hemoptysis or for differential diagnosis from lung malignancy, our data have revealed that surgical resection appears to be a useful intervention and that radiologic diagnosis may not provide decisive information. These findings indicate that it is important for the clinicians to include pulmonary actinomycosis as one of differential diagnoses for refractory pulmonary abnormal lesions to the current usual management.

Keywords:
Actinomycosis; Lung; Hemoptysis; Diagnosis; Treatment