NECROTIZING PNEUMONIA CAUSED BY MIXED INFECTION WITH ACTINOBACILLUS-ACTINOMYCETEMCOMITANS AND ACTINOMYCES-ISRAELII - CASE-REPORT AND REVIEW

Actinobacillus actinomycetemcomitans is an important cause of human pu lmonary infections, either alone or with Actinomyces species. It may b e critical to isolate Actinobacillus in patients with pulmonary infect ion for selection of an effective antimicrobial regimen. Clindamycin h as superseded penicillin as the sole antimicrobial drug for anaerobic bacterial necrotizing pneumonia and abscess. In the case presented her ein, therapy with clindamycin failed to halt worsening necrotizing pne umonia or to prevent hematogenous dissemination. After clindamycin-res istant A. actinomycetemcomitans in addition to Actinomyces israelii we re isolated, the patient was treated with penicillin, ciprofloxacin, a nd cefazolin and was ultimately cured.