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- Title
A Rare Cause of Massive Pulmonary Hemorrhage: Invasive Actinomycosis.
- Authors
Kara, Bilge Yılmaz; İnecikli, Mehmet Fatih; Memoğlu, Melek; Bedir, Recep; Kostakoğlu, Uğur; Özyurt, Songül; Sevilgen, Gökçen; Batçık, Şule; Şahin, Ünal
- Abstract
Pulmonary actinomycosis is a severe clinical condition that may cause death if unrecognized. It may occur in patients who were previously healthy or may develop in patients with chronic immunosuppressant conditions. Presently described is a rare case of massive pulmonary hemorrhage with a related angioinvasive Actinomyces infection. A 52-year-old formerly immunocompetent man was admitted to the hospital due to blood-streaked sputum. A computed tomography image of the thorax taken after the patient’s clinical status suddenly worsened revealed total collapse of the left lung. No tumoral lesion was observed, but extensive necrosis of the mucosa of both main bronchi with massive hemorrhage in the left main bronchus was noticed in an urgent bronchoscopy performed in the intensive care unit. A histopathological examination of the mucosal punch biopsy demonstrated aggregates of filamentous Grampositive organisms indicating Actinomyces infection. Selective embolization of a branch of the feeding artery was successful to control the hemorrhage, but necrotizing pneumonia emerged and the patient could not be discharged from the intensive care unit. He was later lost despite 40 days of treatment with intravenous penicillin-G plus antifungal therapy. Pulmonary angioinvasive infections like actinomycosis must be kept in mind in the absence of bronchial carcinoma or other frequently encountered diseases in cases of massive pulmonary hemorrhage.
- Subjects
HEMORRHAGE; ACTINOMYCOSIS; IMMUNOSUPPRESSIVE agents
- Publication
Respiratory Case Reports, 2018, Vol 7, Issue 2, p86
- ISSN
2147-2475
- Publication type
Article
- DOI
10.5505/respircase.2018.72792