Pulmonary actinomycosis, a rare disease

Actinomicosis pulmonar, una enfermedad escasa

INTRODUCTION: actinomycosis is a rare chronic disease, caused mainly by gran positive anaerobic actinomycetes known as Actinomyces israelii. It normally inhabits the oropharynx, the gastrointestinal and genitourinary tracts, and can therefore be isolated in 12 to 52 % of healthy individuals. In this case, a patient with pulmonary actinomycosis is presented.

CASE DESCRIPTION: this is an 81-year-old male patient with a history of lung mass, Chronic Obstructive Pulmonary Disease (COPD), and smoking; the patient is reconsultant due to clinical pictures consisting of unquantified thermal rises, cough with green expectoration and mobilization of secretions, dyspnea of medium efforts. During hospitalizations, Positron Emission Tomography/Computed Tomography (PET/CT) studies and tomography-guided biopsy were performed, which showed hypermetabolic lesions and actinomyces colonies with non-necrotizing granulomas, respectively, findings compatible with the clinical picture described, making a diagnosis of chronic non-necrotizing granulomatous pneumonia. with numerous actinomices colonies and treatment with amoxicillin is started for 6 months.

DISCUSSION: often the symptomatology of a patient with actinomycosis is confused with a neoplasm or tuberculosis because the diagnosis is difficult to establish, since symptoms and nonspecific images are initially presented. The diagnosis is established on many occasions after having exhausted a significant number of complementary tests, including a lung biopsy