• Journal of Chest Surgery
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• v.35 no.12
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• pp.914-916
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• 2002

Actinomycosis of the lung is a chronic, suppurative granulomatous infection which is caused by Actinomyces israelii. It is believed to enter the thorax by way of the bronchial tree, by aspiration of contaminated aerosol particles in the upper digestive tract. Symptoms of chronic cough, sputum, hemoptysis, low grade fever, chest pain, and weight loss are common. Chest X-ray shows mass like lesion, pulmonary infiltration, abscess, and tuberculosis like lesion, which makes differential diagnosis from lung cancer very difficult. Surgical intervention is needed for the diagnosis and treatment, and diagnosis of actinomycosis is achieved when histologic examination reveals sulfur granules containing filamentous organisms. Penicillin is the drug of choice. Two or three months of penicillin treatment is recommended to treat the oropharyngeal or dental abscess to avoid recurrences. We present a case of actinomycosis which is suspected to malignant with review of literatures.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.467-471
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• 1996

We report a case of a 20-year-old woman who presented with fever, dry cough and pulmonary consolidation at the left upper lobe on chest radiograph. Fiberoptic bronchoscopy revealed obstruction of the left upper lobar bronchus with exophytic mass and multiple nodular protruding lesions at the left main bronchus. Endobronchial actinomycosis was confirmed by demonstration of sulfur granule through the bronchoscopic biopsy of nodular lesion. Intravenous administration of penicillin G followed by oral tetracycline therapy for 5 months resulted in complete recovery of symptoms which had been present for 3 months prior to therapy. Infiltrative consolidation on the chest X-ray disappeared and all the lesions shown by bronchoscopy were nearly normalized after 6 months only to remain small nodular remnants at the left main bronchus. Endobronchial actinomycosis should be included in the differential diagnosis of endobronchial mass.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.1
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• pp.82-86
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• 2001

Actinomycosis is chronic, granulomatous, suppurative and fibrosing disease caused by Actinomyces. Actinomyces are anaerobic, G(+), non-acid-fast, branched, filamentous bacteria. The most commonly found microorganism is Actinomyces israelii. Common site for isolation of actinomyces are dental plaque, dental caries, calculus, and tonsillar crypt. A breach in the integrity of the mucosa by direct trauma or following a fracture, tooth extraction, root canal therapy or some intraoral surgical procedure is thought to be the most likely portal of entry. This is a case report of 23 years old male with cervicofacial actinomycosis developed after extraction and treated with surgical excision and antibiotics.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.197-200
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• 2004

A 75 year old woman was admitted for evaluation of right lung mass. She was not a smoker. She had been diagnosed as uterine prolapse and during preoperative assessment a lung mass was found incidentally on simple chest X-ray. On chest CT scan, $3.5{\times}2$ cm sized homogeneous mass was located in the anterior segment of right upper lobe and there were multiple calcified lymph nodes in both hilum and mediastinal area. We performed diagnostic bronchoscopy, but no definite endobronchial mass was found. Next we did CT guided percutaneous fine needle aspiration biopsy. On microscopy, sulfur granules consisting of multiple granular basophilic centers with hyaline projection of branching filaments were noted. From this finding we made a diagnosis of pulmonary actinomycosis.

• Tuberculosis and Respiratory Diseases
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• v.58 no.6
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• pp.576-581
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• 2005

Background : Thoracic actinomycosis is a relatively uncommon anaerobic infection caused by Actinomyces israelii. There have been only a few case reports of endobronchial actinomycosis. The aim of this study was to evaluate the clinical manifestation and treatment of endobronchial actinomycosis. Material and Methods : Seven patients with endobronchial actinomycosis, who were diagnosed in the past 10 years, were retrospectively reviewed. Results : Cough and sputum were the most common symptoms. The chest radiograph and computed tomography showed necrotic consolidation (n=3), atelectasis (n=2), mass (n=1) and an endobronchial nodule (n=1). Proximal broncholithiasis was observed in five patients. All cases were initially suspected to have either lung cancer or tuberculosis. In these patients, the median duration of intravenous antibiotics was 3 days (range 0-12 days) and the median duration of oral antibiotics was 147 days (range 20-412 days). Two patients received oral antibiotic therapy only. There was no clinical evidence of a recurrence. Conclusion : Endobronchial actinomycosis frequently manifests as a proximal obstructive calcified endobronchial nodule that is associated with distal post-obstructive pneumonia. The possibility of endobronchial actinomycosis is suggested when findings of broncholithiasis are present at chest CT. The traditional recommendation of 2-6 weeks of intravenous antibiotics and 6-12 months of oral antibiotic therapy are not necessarily essential in all cases of endobronchial actinomycosis.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1058-1066
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• 1998

Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.125-130
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• 2008

Endobronchial actinomycosis is a rare chronic suppurative granulomatous infection of the bronchus, and this is sometimes related with a foreign body or a broncholith. The traditional treatment of endobroncial actinomycosis is intravenous antibiotics for 2 to 6 weeks and then oral antibiotics therapy for 6 to 12 months. We report here on 2 cases of endobronchial actinomycosis that were associated with a broncholith and a foreign body, respectively. Surgery followed by short term antibiotics therapy for only 20 days and 34 days, respectively, was effective as treatment for the endobronchial actinomycosis in our cases. After treatment, there were no complications or recurrence during the following period. We suggest that short term antibiotics therapy combined with a surgical operation might be effective as treatment for primary endobronchial actinomycosis, and especially when this illness is combined with a foreign body or a broncholith, as compared with traditional long term antibiotic therapy.

• Tuberculosis and Respiratory Diseases
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• v.57 no.6
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• pp.584-588
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• 2004

Pulmonary aspergilloma usually arises in preexisting lung cavities characterized by recurrent hemoptysis. Although surgical resection of the aspergilloma is the best treatment, most patients are poor candidates for surgery because of far-advanced underlying pulmonary disease. On the other hand, pulmonary actinomycosis is a chronic, indolent bacterial infection and follows aspiration of oropharyngeal material. Bronchiectasis and obstructive lung disease are often associated underlying conditions. We report a case of pulmonary aspergilloma in bronchogenic cyst associated with an actinomycosis in 21-year-old woman treated by thoracoscopic surgery with a review of literature.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.236-239
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• 2006

A 32 year-old man was transferred to our hospital due to blood-tinged sputum for 15 days. He had been treated at a private hospital for recurrent pneumonia. The chest X-ray showed an atelectasis on the right middle lobe. Computed tomography of the chest demonstrated a broncholith on right middle lobar bronchus with lobar atelectasis of the right middle lobe. We tried to remove the broncholith through fiberoptic bronchoscopy, but could not remove it. Therefore, we performed surgical removal of broncholith and the right middle lobectomy. The cause of broncholith was identified as actinomycosis by pathologic examination. The broncholith caused by actinomycosis is rare. We report a rare case of broncholithiasis with recurrent obstructive pneumonia caused by actinomycosis, which was treated by surgical operation.

• Korean Journal of Microbiology
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• v.55 no.1
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• pp.58-60
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• 2019

Anaerobic Gram-negative bacterium Prevotella intermedia is a part of normal flora of the oral cavity and associated with various types of oral and systemic diseases. We present here a draft genome sequence of P. intermedia ATCC 15032, originally isolated from cervicofacial actinomycosis. The genome is 2,848,426 bp in length and has a GC content of 43.45%. The genome includes 2,358 protein-coding genes, 5 rRNAs, and 43 tRNA. The sequence information will provide important clues in understanding the genome diversity within the bacterial species, and genetic basis for phenotypic differences among P. intermedia strains.