Korean J Crit Care Med.  2010 Dec;25(4):249-252. 10.4266/kjccm.2010.25.4.249.

A Case Report of Rapidly Progressive Empyema Caused by Pulmonary Actinomycosis: A Case Report

• Park SJ
• Ahn YC
• Park SK
• Kim MJ
• Kang SH
• Jang HJ
• Koh Y

• KMID: 2228188
• DOI: http://doi.org/10.4266/kjccm.2010.25.4.249

Abstract

Pulmonary actinomycosis is an indolent and slowly progressive infectious disease, accompanied by pleural effusion and empyema in about 50% of cases. The size of the effusion is usually small, though, and it responds to appropriate antibiotics. We report a case of rapidly progressing, severe empyema leading to respiratory failure that was caused by pulmonary actinomycosis. A 57-year-old man presented with pleuritic chest pain for 5 days. The initial plain chest radiograph and CT scan showed pleural effusion. Gross pus was observed during the thoracentesis and laboratory test of pleural effusion revealed empyema. In spite of empirical antibiotics and chest tube drainage, the empyema rapidly progressed and the patient reached respiratory failure. Mechanical ventilation applied and decortication via video-assisted thoracotomy was performed. Microscopic examination of both the pleural and adjacent lung biopsy specimen revealed actinomycosis.

Keyword

actinomycosis; empyema; respiratory failure

MeSH Terms

Actinomycosis
Anti-Bacterial Agents
Biopsy
Chest Pain
Chest Tubes
Communicable Diseases
Drainage
Empyema
Humans
Lung
Middle Aged
Pleural Effusion
Respiration, Artificial
Respiratory Insufficiency
Suppuration
Thoracotomy
Thorax
Anti-Bacterial Agents