PT  - JOURNAL ARTICLE
AU  - Dietmar W. Geiger
AU  - Ingo Stehle
AU  - Steffen Decker
AU  - Thomas Graeter
AU  - Jürgen R. Fischer
TI  - Thoracic actinomycosis changing with time
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P573
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P573.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P573.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Background: Actinomycosis, a very rare disease, with nonspecific symptoms was first described by J. Israel in 1878. It has been a diagnostic and therapeutic problem ever. The clinical picture has changed with social and medical development. We describe our experience.Methods: Between 2001 and 2010 all cases of actinomycosis treated at our hospital were recorded and analyzed in comparison with the description in the literature.Results: A total of 11 patients were diagnosed and treated, 8 male and 3 female, age 37 to 81, average age of 61 years. Dental status was fine in 91% (10). Alcohol and tobacco abuse were found in only 27% (3), previous thoracic surgery in 18% (2). Symptoms of cough were mentioned in 91% (10), with hemoptysis in 36% (4), and chest pain in 18% (2). Fever was found in 27% (3), elevated CRP and leucocytosis in 64% (7) of the cases. In 36 % (4) we suspected pneumonia or abscess, in 64 % (7) malignancy. The time to diagnosis ranged from 3 weeks to 1 year. Antibiotic treatment and if necessary surgery (n=6) cured patients in 91% (10). In those patients with early diagnosis within 3 weeks surgical intervention was necessary in 33 % of the patients, whereas later diagnosis was associated with surgery in 66%. One patient developed rapid progressive NSCLC under the treatment of actinomycosis.Conclusions: Thoracic actinomycosis no longer manifests itself as in the last century in our pneumological patient population. Clinical signs and radiological imaging are often similar to malignant disease. Simultaneous occurrence of malignancy and actinomycosis is possible and can be cause and consequence of immunological deficiency. Early diagnosis and consistently antibiotic treatment may prevent the need for surgery.