Two cases of endobronchial actinomycosis that were cured by bronchoscopic removal and short-term antibiotic therapy

내시경적 제거와 단기간 항생제 투여로 완치된 기관지 방선균증 2예

Actinomycosis is an uncommon, chronic granulomatous, suppurative disease related to Actinomyces israelii, which is a natural inhabitant of the oropharyngeal cavity and the major human pathogen of actinomycosis. In the past, dramatic presentation of thoracic actinomycosis, in conjunction with prominent chest pain and cutaneous fistulas that discharge sulfur granules, has frequently been reported. However, more recent data indicate that chest wall or rib involvement is now much less common than was previously encountered. This could result in more favorable responses to short-term intravenous antibiotic therapy. Foreign-body-associated actinomycosis is a very rare type of thoracic actinomycosis. We report two cases of endobronchial actinomycosis associated with a foreign body. In both cases, the foreign body was successfully removed by bronchoscopy. Each patient was treated with antibiotics for about 70 days. The duration of antibiotic therapy was relatively short, as compared to conventional therapy. Nevertheless, there was no recurrence or complications over 1 year.

이물질과 관련된 기관지내 방선균증은 기침, 가래, 호흡곤란, 반복되는 폐렴을 특징으로 하는 구인두 상재균인 Actinomyces israelii에 의한 감염으로 과거에는 초기 진단이 되지 않아 수술적인 치료 및 장기간의 항생제 치료를 필요로 하였다. 저자들은 기침, 혈담 등을 주소로 내원하여 이물질에 의한 기관지내 방선균증으로 진단된 2명의 환자를 경험하였다. 기관지 내시경을 통해 이물질이 비교적 잘 제거된 경우에는 고식적인 항생제 요법보다 더 짧은 기간의 항생제 치료만으로도 성공적인 치료를 하였기에 보고하는 바이다.