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Vol. 13. Issue 2.
Pages 275-280 (March - April 2007)
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Vol. 13. Issue 2.
Pages 275-280 (March - April 2007)
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Actinomicose pulmonar – A propósito de um caso clínico
Pulmonary actinomycosis – A case report
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Anabela Salgueiro Marques1,
Corresponding author
anabela.s.marques@sapo.pt

Correspondência: Rua Ferrarias Del Rei n° 21, Moradia B4 2730-269 Barcarena - Oeiras Fax: +214260451.
, Nuno Lopes2, Mafalda Guimarães2, José Vera3, Miguel Monteiro4,7, Isabel Serrano5, Manuel Costa Matos6, Helena Oliveira8
1 Assistente Eventual de Medicina Interna
2 Interno do Internato Complementar de Medicina Interna
3 Assistente Graduado de Medicina Interna
4 Chefe de Serviço de Pneumologia
5 Assistente Graduado de Anatomia Patológica
6 Serviço de Medicina, Centro Hospitalar de Cascais
7 Serviço de Pneumologia, Centro Hospitalar de Cascais
8 Serviço de Anatomia Patológica, Centro Hospitalar de Cascais
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Resumo

A actinomicose pulmonar é uma situação clínica rara mas de diagnóstico importante e nem sempre fácil. Trata-se de uma infecção crónica supurativa causada por uma bactéria anaeróbia gram-positiva microfilamentosa designada por Actinomyces.

Apresenta-se o caso clínico de um homem de 32 anos, previamente saudável, sem co-morbilidades, que desenvolve um quadro de febre, associada a tosse produtiva e toracalgia direita.

Verificou-se a existência de alterações radiológicas sugestivas de pneumonia lobar superior direita. Iniciou terapêutica antibiótica com amoxicilina/clavulanato, com melhoria clínica e analítica, contudo com persistência do achado radiológico, acabando por realizar tomografia computorizada que revelou tratar-se de condensação lobar superior direita com características discretamente expansivas.

A investigação etiológica permitiu identificar o agente responsável, o Actinomyces.

Os autores fazem uma breve revisão desta patologia.

Palavras-chave:
Actinomicose pulmonar
Actinomyces
Key-Words:
Pulmonary actinomycosis
Actinomyces
Abstract

Pulmonary Actinomycosis is a rare clinical situation whose diagnosis is important but not always easy to make. It is a chronic infection caused by the anaerobic grampositive filamentous bacterium Actinomyces.

We present a case report of a 32 year-old man previously healthy with no co-morbidities, with fever, productive cough and chest pain, with radiological evidence of right superior lobar pneumonia.

He began antibiotic therapy with amoxicillin/clavulanate, with good clinical and analytic response, but the radiological finding persisted. Thoracic computerized tomography revealed discretely expansive right lobar condensation.

The epidemiological investigation identified actinomyces. The authors present this case and a brief review of this disease.

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Bibliografia
[1.]
G. Mabeza, J. Macfarlane.
Pulmonary actinomycosis.
Eur Respir J, 21 (2003), pp. 545-551
[2.]
D.F. Bennhoff, Actinomycosis:.
Diagnostic and Terapeutic considerations and a review of 32 cases.
Laryngoscope, 94 (1984), pp. 1198-1217
[3.]
K.P. Schaal, H. Lee.
Actinomycete infections in humans – a review.
Gene, 115 (1992), pp. 201-211
[4.]
W.C. Weese, I.M. Smith.
A study of 57 cases of Actinomycosis over a 36-year period – A Diagnostic ‘failure’ with good prognosis after treatment.
Arch Intern Med, 135 (1975), pp. 1562-1568
[5.]
M.J. Hsieh, H.P. Liu, J.P. Chang, et al.
Thoracic actinomycosis.
Chest, 104 (1993), pp. 366-370
[6.]
M. Bates, G. Cruickshank.
Thoracic actinomycosis.
Thorax, 12 (1957), pp. 99-124
[7.]
M. Gomez, C. Ray, L. Allenspach, P. Kvale.
Endobronchial actinomycosis associated with a foreign body.
J Bronchol, 12 (2005), pp. 54-55
[8.]
S. Chouabe, D. Perdu, G. Deslée, D. Milosevic, E. Marque, F. Lebargy.
Endobronchial actinomycosis associated with foreign body: four cases and a review of literature.
Chest, 121 (2002), pp. 2069-2072
[9.]
J. Choi, W. Koh, T. Kim, K. Lee, J. Han, H. Kim, O. Kwon.
Optimal duration of IV and Oral antibiotics in the treatment of thoracic actinomycosis.
Chest, 128 (2005), pp. 2211-2217
[10.]
S. Endo, F. Murayama, T. Yamaguchi, et al.
Surgical considerations for pulmonary actinomycosis.
Ann Thorac Surg, 74 (2002), pp. 185-190
Copyright © 2007. Sociedade Portuguesa de Pneumologia
Pulmonology
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