Pulmonary actinomycosis

Alternative Names: Actinomycosis - pulmonary

Pulmonary actinomycosis is a rare bacterial lung infection.

Causes of Pulmonary actinomycosis

Pulmonary actinomycosis is caused by a species of bacteria normally found in the mouth and gastrointestinal tract, where they do not usually cause harm. However, poor dental hygiene and dental abscess can increase your risk for face, jaw, and lung infections caused by these bacteria.

Alcohol abuse, having scars on the lungs (bronchiectasis), and emphysema are all associated with lung infections caused by actinomycosis.

The disease is rare in the U.S., with only about 100 confirmed cases per year. It may occur at any age, but most patients are 30 - 60 years old. Men get this infection more often than women do.

Pulmonary actinomycosis Symptoms

The infection usually comes on slowly. It may be weeks or months before a doctor makes a diagnosis.

Symptoms include:

• Chest pain when taking a deep breath
• Cough with phlegm (sputum)
• Fever
• Lethargy
• Night sweats
• Shortness of breath
• Weight loss

Tests and Exams

Tests that may be done include:

• Bronchoscopy with culture
• Complete blood count (CBC)
• Chest x-ray
• Chest CT scan
• Lung biopsy
• Modified AFB smear of sputum
• Sputum culture
• Sputum Gram stain
• Thoracentesis with culture
• Tissue culture
• Tissue and fluid analysis

Treatment of Pulmonary actinomycosis

The goal of treatment is to cure the infection. However, many patients take a long time to get better. To be cured, you may need to receive penicillin through a vein (intravenously) for 4 - 6 weeks, followed by several months of penicillin by mouth. Some people need up to 18 months of treatment.

If you cannot take penicillin, other antibiotics are available. These include tetracyclines, macrolides, or clindamycin.

Surgery may be needed to drain fluid from the lungs and control the infection.

Prognosis (Outlook)

Most people get better after treatment with antibiotics.

Potential Complications

• Brain abscess
• Destruction of parts of the lungs
• Emphysema
• Meningitis
• Osteomyelitis (bone infection)

When to Contact a Health Professional

Call your health care provider if:

• You have symptoms of pulmonary actinomycosis
• Your symptoms get worse or do not improve with treatment
• You develop new symptoms

Prevention of Pulmonary actinomycosis

Good dental hygiene may help reduce your risk of getting actinomycosis.

Brook I. Actinomycosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 350.

Respiratory system

Review Date: 5/25/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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