A case of pulmonary actinomycosis diagnosed from anaerobic culture of peripheral pulmonary tissue acquired by bronchoscopy using endobronchial ultrasonography with a guide sheath
Yae Yoshida Masayoshi Nishijima Nobuhiko Sawa Shigeki Kakuno Hatsuki Shimazu Takao Kamimori
Department of Respiratory Medicine, Yodogawa Christian Hospital
Pulmonary actinomycosis is a chronic pyogenic granulomatous disease. We herein report a case of pulmonary actinomycosis diagnosed from anaerobic culture of peripheral pulmonary tissue acquired by bronchoscopy using endobronchial ultrasonography with a guide sheath (EBUS-GS). A 47-year-old Japanese woman with a history of dental abscess visited our hospital because of repeated pneumonia for four months. Chest X-ray and computed tomography showed consolidation in the right upper lobe. Laboratory data showed an elevation of C-reactive protein. Anaerobic culture of pulmonary tissue taken from the right B3a with bronchoscopy using endobronchial ultrasonography with a guide sheath method showed actinomycosis. Her clinical symptoms and chest X-ray and computed tomography findings improved after four months' medication with penicillin antibiotics. Among the 105 cases of pulmonary actinomycosis diagnosed over the past 10 years in Japan, only four cases were diagnosed by bronchoscopy from anaerobic culture of peripheral pulmonary tissue. Furthermore, two of four cases were diagnosed by EBUS-GS. For the diagnosis of pulmonary actinomycosis, it is important to take pulmonary tissue from the center of the granuloma using EBUS-GS and examine an anaerobic culture of the specimen.
Pulmonary actinomycosis Peripheral pulmonary lesion (tissue) Anaerobic culture of pulmonary tissue Endobronchial ultrasonography with a guide sheath (EBUS-GS) Center of the granuloma
Received 6 Mar 2020 / Accepted 19 Oct 2020
AJRS, 10(1): 37-40, 2021