H. Kremer et M. Ross, THORACIC ACTINOMYCOSIS MASKING AS A CENTR AL BRONCHIAL-CARCINOMA, Deutsche Medizinische Wochenschrift, 118(32), 1993, pp. 1150-1154
A 41-year-old cachectic woman (weight 42.7 kg, height 1.65 m) was admi
tted to hospital because a chest radiogram had suggested a left centra
l bronchial carcinoma. Four days previously she had noted for the firs
t time a firm elastic swelling parasternally in the fourth intercostal
space. This swelling was directly aspirated by needle after bronchosc
opic results had been non-specific. Surprisingly, pus containing actin
omyces filaments was aspirated. Computed tomography confirmed a parame
diastinal abscess, 8 x 5 x 6 cm, which had infiltrated into the left t
horacic wall. The abscess was incised and drained. After treatment for
two weeks, initially with three times daily 10 mega penicillin G intr
avenously, followed by erythromycin, 500 mg twice daily for 12 weeks,
the thoracic actinomycosis was no longer demonstrable radiologically a
nd by ultrasound. - It is suggested that in any unclear pulmonary infi
ltrate without evidence of tuberculosis or carcinoma actinomycosis sho
uld be included in the differential diagnosis.