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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

A case of pulmonary infection with Actinomyces and Nocardia identified in bronchial washing fluid

Hideto Oshita*  Naokazu Watari  Tatsuki Takahashi  Misato Senoo  Kunihiko Funaishi  Ken Okusaki 

Department of Internal Medicine, Mihara Medical Association Hospital
*Present address: Department of Respiratory Internal Medicine, Federation of National Public Service and Affiliated Personnel Mutual Aid Associations, Yoshijima Hospital

ABSTRACT

A chest computed tomography (CT) in a 57-year-old woman showed centrilobular shadows in the left lower lobe about 1 year ago. She complained of bloody sputum, and a further chest CT showed increased shadowing, for which bronchoscopy was performed. Gram staining of bronchial washing fluid showed gram-positive rods with branching filamentous hyphae, corresponding to Actinomyces graevenitzii and Nocardia wallacei in culture. Antimicrobial treatment was discontinued after a short time due to side effects. However, after carious tooth treatment and guidance about soil exposure avoidance, her bloody sputum improved, and the shadow had almost disappeared on CT. For actinomycete infections, countermeasures against the sources of exposure to the infection should be actively undertaken.

KEYWORDS

Actinomycetes  Soil exposure  Carious tooth  Mixed infection 

Received 27 May 2021 / Accepted 12 Jul 2021

AJRS, 10(5): 398-401, 2021

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