Pulmonary Actinomycosis

Pulmonary actinomycosis is a chronic suppurative granulomatous lung infection caused by anaerobic Actinomyces israelii, characterized by multiple abscesses, sinus tracts, and sulfur-yellow granular pus, with fibrosis. The organism is normal oral/dental/tonsillar flora; infection follows poor oral hygiene and aspiration of secretions; it may also spread hematogenously or by direct extension from abdominal/cervicofacial foci (~1/3 are cervicofacial/thoracoabdominal).

Common Symptoms

Periostitis; weight loss; hemoptysis; night sweats; fatigue; low fever

Causes and Pathogenesis

Actinomyces dwells in oral mucosa, gums, tonsils, and colon. With lowered resistance, oral secretions are aspirated into the respiratory tract, first affecting bronchi then lung parenchyma; esophageal/abdominal foci may spread through the diaphragm to pleura/lung. It causes suppurative pneumonia and may penetrate fissures/pleura/chest wall/ribs forming sinus tracts, or disseminate hematogenously. Actinomyces are prokaryotes reproducing by binary fission (not spores); most are anaerobic/microaerophilic and grow in tightly packed visible macroscopic granules in tissue. A. israelii is most common; A. naeslundii, A. viscosus also cause disease. Pathology: multiple abscesses, fistulas, granulation proliferation, and fibrosis; sulfur granules in pus/sinus drainage; late fibrosis; pleural involvement causing empyema and chest-wall fistulas; destruction and proliferation proceed simultaneously.

Treatment

High-dose penicillin, surgical treatment

Preventive Measures

1. Food hygiene; avoid spoiled food. 2. Oral hygiene; use antibiotics promptly after tooth extraction. 3. Treat dental/tonsillar foci early to eradicate actinomycotic sources.

Department to Visit

It is recommended to visit the Respiratory department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.