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Lee, Lee, Oh, Choi, Seo, Kim, Na, and Hwang: Two Cases of Endobronchial Actinomycosis that were Cured by Operation and Short Term Antibiotics Therapy
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(2): 125-130.

Published online: 31 August 2008

DOI: https://doi.org/10.4046/trd.2008.65.2.125

Two Cases of Endobronchial Actinomycosis that were Cured by Operation and Short Term Antibiotics Therapy

Yong Kwan Lee, M.D.1, Ho Sung Lee, M.D.1, Mee Hye Oh, M.D.2, Jae Sung Choi, M.D.1, Ki Hyun Seo, M.D.1, Yong Hoon Kim, M.D.1, Ju Ock Na, M.D.1, Hun Gyu Hwang, M.D.1

1Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.

2Department of Pathology, Soonchunhyang University College of Medicine, Cheonan, Korea.

Address for correspondence: Ju Ock Na, M.D. Department of Internal Medicine, Soonchunhyang University College of Medicine, 23-20, Bongmyeong-dong, Cheonan 330-721, Korea. Phone: 82-41-570-3666, Fax: 82-41-574-5762, juokna@hanmail.net

Received 30 May 2008       Accepted 8 July 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Endobronchial actinomycosis is a rare chronic suppurative granulomatous infection of the bronchus, and this is sometimes related with a foreign body or a broncholith. The traditional treatment of endobroncial actinomycosis is intravenous antibiotics for 2 to 6 weeks and then oral antibiotics therapy for 6 to 12 months. We report here on 2 cases of endobronchial actinomycosis that were associated with a broncholith and a foreign body, respectively. Surgery followed by short term antibiotics therapy for only 20 days and 34 days, respectively, was effective as treatment for the endobronchial actinomycosis in our cases. After treatment, there were no complications or recurrence during the following period. We suggest that short term antibiotics therapy combined with a surgical operation might be effective as treatment for primary endobronchial actinomycosis, and especially when this illness is combined with a foreign body or a broncholith, as compared with traditional long term antibiotic therapy.

Keywords: Endobronchial actinomycosis, Treatment, Short term antibiotics

Figures and Tables

Figure 1
Case 1: Chest radiography showed consolidation at RML (Right middle lobe) lateral segment.
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Figure 2
Case 1: Chest computed tomography showed obstructive bronchitis with Bronchiolith in RML (Right middle lobe), lateral segment.
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Figure 3
Case 1: Bronchoscopy showed near total obstruction by yellowish hard nodule at RML (Right middle lobe) lateral segment.
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Figure 4
Case 1: Microscopically, (A) the resected lung shows diffuse dilated bronchi or bronchioles containing necrotic material (H&E stain, ×10). (B) An actinomycetes colony composed by radially arranged filamentous bacilli is noted (GMS stain, ×200).
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Figure 5
Case 2: Chest radiography showed RML (Right middle lobe) collapse.
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Figure 6
Case 2: Bronchoscopy showed near total obstruction of right intermedius branch with a bone like material.
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Figure 7
Case 2: Microscopic finding shows actinomycetes colonies, composed by radially arranged filamentous bacilli in (A) (GMS stain, ×100) & (B) (Gram stain, ×100).
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