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Free Content Primary pulmonary actinomycosis: a retrospective analysis of 145 cases in mainland China

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OBJECTIVE: To improve our understanding of pulmonary actinomycosis.

METHODS: A retrospective analysis of 145 cases in mainland China was conducted.

RESULTS: The male:female ratio was 2.7:1. Mean age at diagnosis was 48 years (± 12). Main symptoms were cough (87.6%), expectoration (40%), blood-stained sputum (37.2%), fever (26.9%), chest pain (24.8%) and haemoptysis (16.6%). Eighty-eight (60.7%) patients had no underlying disease. Only five patients received a correct initial diagnosis; 60 patients were misdiagnosed with lung cancer, followed by pulmonary tuberculosis (TB) and lung abscess. Most patients were diagnosed using surgical resection, transthoracic needle aspiration or flexible bronchoscopy. Sixty-seven patients received penicillin G, and one patient did not receive any antibiotics after surgery. The mean duration of treatment with antibiotics was 4.5 months (±3.7). Overall, 110 (75.9%) patients were fully cured, 4 died, 1 was lost to follow-up, and a record of the prognosis was not available for 30 patients. Mean duration of follow-up was 26 months (± 32).

CONCLUSION: Pulmonary actinomycosis is a rare bacterial infection and is often misdiagnosed as lung cancer or pulmonary TB. The definitive diagnosis depends on pathology; sulfur granules are suggestive, but not specific. Penicillin G is the standard treatment. The optimal duration of antibiotic treatment merits further investigation.
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Keywords: actinomycosis; lung; pulmonary; retrospective analysis; thoracic

Document Type: Research Article

Publication date: 2017-07-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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