Pulmonary actinomycosisActinomycosis - pulmonary
Pulmonary actinomycosis is a rare bacterial lung infection.
Pulmonary actinomycosis is caused by certain bacteria normally found in the mouth and gastrointestinal tract, where they do not usually cause harm. Poor dental hygiene and dental abscess can increase your risk of 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. It may occur at any age, but most patients are 30 to 60 years old. Men get this infection more often than women.
The infection usually comes on slowly. It may be weeks or months before a doctor makes a diagnosis.
Symptoms include any of the following:
- Chest pain when taking a deep breath
- Cough with phlegm (sputum)
- Night sweats
- Shortness of breath
- Weight loss
Exams and Tests
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
- Tissue and sputum Gram stain
- Thoracentesis with culture
- Tissue culture
- Tissue and fluid analysis
The goal of treatment is to cure the infection. Many patients take a long time to get better. To be cured, you may need to receive the antibiotic penicillin through a vein (intravenously) for 4 to 6 weeks. Then you need to take penicillin by mouth. Some people need up to 18 months of treatment.
If you cannot take penicillin, your doctor will prescribe other antibiotics.
Surgery may be needed to drain fluid from the lungs and control the infection.
Most people get better after treatment with antibiotics.
When to Contact a Medical 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
- You have a fever 101°F or higher.
Good dental hygiene may help reduce your risk of getting actinomycosis.
Brook I. Actinomycosis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 337.
Russo TA. Agents of actinomycosis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 255.
Review Date: 5/12/2014
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.