Bronchopulmonary actinomycosis associated with hiatal hernia

Alessandro Andreani, Alberto Cavazza, Alessandro Marchioni, Luca Richeldi, Massimiliano Paci, Giulio Rossi

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To describe clinicoradiologic and histopathologic features of bronchopulmonary actinomycosis and to determine whether hiatal hernia (HH) is a potential predisposing factor for bronchopulmonary actinomycosis. PATIENTS AND METHODS: We reviewed the medical charts of 10 patients who had bronchopulmonary actinomycosis between November 1, 2002, and January 31, 2008. Complete clinical data, radiologic studies (chest radiographs and computed tomographic scans), and histopathologic features were assessed to investigate clinical manifestations and predisposing factors related to bronchopulmonary actinomycosis. RESULTS: The series consisted of 6 men and 4 women, with a mean age of 63.5 years; 8 of the patients were smokers. Cough and fever were the most common symptoms. Chest imaging showed mass-like consolidation in 4 patients, bronchial thickening or lung atelectasis with pleural thickening in 2 patients each, and perihilar irregular mass or multiple bilateral nodules in 1 patient each. Primary or metastatic lung cancer was suspected clinically in 8 of the 10 patients. Foreign body-related endobronchial actinomycosis was diagnosed in 6 patients, 5 of whom had HH; only 1 had gastroesophageal reflux-related symptoms. Because of bronchial obstruction, rigid bronchoscopy was performed in 3 patients, lobectomy in 2, and atypical resection in 1. Antibiotic therapy with amoxicillin was given to all patients, with resolution of actinomycosis. CONCLUSION: Bronchopulmonary actinomycosis is a rare condition that mimics pulmonary malignancy on clinical and radiologic grounds. Diagnosis relies on an accurate patient history and histopathologic examination. Although further confirmation is required, esophageal HH appears to be a potential predisposing factor.

Original languageEnglish
Pages (from-to)123-128
Number of pages6
JournalMayo Clinic Proceedings
Volume84
Issue number2
DOIs
Publication statusPublished - 2009

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Actinomycosis
Hiatal Hernia
Causality
Thorax
Lung
Pulmonary Atelectasis
Amoxicillin
Bronchoscopy
Gastroesophageal Reflux
Foreign Bodies
Cough
Lung Neoplasms
Fever
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Medicine(all)

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Bronchopulmonary actinomycosis associated with hiatal hernia. / Andreani, Alessandro; Cavazza, Alberto; Marchioni, Alessandro; Richeldi, Luca; Paci, Massimiliano; Rossi, Giulio.

In: Mayo Clinic Proceedings, Vol. 84, No. 2, 2009, p. 123-128.

Research output: Contribution to journalArticle

Andreani, A, Cavazza, A, Marchioni, A, Richeldi, L, Paci, M & Rossi, G 2009, 'Bronchopulmonary actinomycosis associated with hiatal hernia', Mayo Clinic Proceedings, vol. 84, no. 2, pp. 123-128. https://doi.org/10.4065/84.2.123
Andreani, Alessandro ; Cavazza, Alberto ; Marchioni, Alessandro ; Richeldi, Luca ; Paci, Massimiliano ; Rossi, Giulio. / Bronchopulmonary actinomycosis associated with hiatal hernia. In: Mayo Clinic Proceedings. 2009 ; Vol. 84, No. 2. pp. 123-128.
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