PulmonaryactinomycosisCasereportandretrospectiveanalysisoftheliteratureinChina.docVIP

Pulmonary actinomycosis: Case report and retrospective analysis of the literature in China Baiquan Yu1*,Yaxin Liu1*, Fuzhen Lv1# 1Department of Respiratory, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, China *These two authors contribute equally to this work. # Corresponding Author: Fuzhen lv, M.D., Ph.D. Email addresses: Baiquan Yu: yubaiquan76@163.com Yaxin Liu: aliu0707@126.com Fuzhen Lv: lvfuzhen01@ Abstract: Pulmonary actinomycosis is a rare but frequently misdiagnosed disease that is commonly confused with other chronic inflammatory diseases and malignancies. In this report, we aimed to evaluate the clinical manifestations and imaging features of pulmonary actinomycosis for early recognition which could prevent the considerable physical damage caused by delayed diagnosis. We reported a 52-year-old Chinese man, suffered by a 15-day history of cough, copious purulent sputum and intermittent fever, was final diagnosed as pulmonary actinomycosis by B-mode ultrasonic-guided transthoracic needle biopsy. Then 24 confirmed cases, including our patient from year 2005 to 2010, were reviewed and their clinical manifestations, diagnosis and treatment were analyzed. In our series the median age of the patients was 46.5 years, and the male-to-female ratio was 3:1. The most common symptoms include cough, sputum, haemoptysis, fever and chest pain . The main radiological features were peripheral mass or nodule complicated cavity, burr, pleural effusion. Malignancy possessed the highest rate for misdiagnosis (33.3%), followed by pneumonia (25%) and tuberculosis (16.7%) among these cases. Patients were confirmed by fiberoptic bronchoscopy (20.8%), transthoracic needle biopsy (33.3%), or surgery (33.3%). With regard to the treatment, 12 cases (50%) were treated by antibiotics only and 5 cases (20.8%) by surgery only, and 4 cases (16.7%) by surgery combined with antibiotics. When a middle-aged male patient presents with cough, sputum and haem