Pulmonary actinomycosis

Overview lung actinomycosis disease (pulmonary actinomycosis) from the anaerobic system of the Israeli Guofang Line pulmonary infection caused by chronic suppurative granulomatous disease. The normal oral bacteria for dental caries, the tonsil crypts always keep the bacteria. Because the majority of poor oral hygiene, containing respirable particles actinomycosis incidence of secretions. Can also be disseminated from the blood or abdominal lesions spread directly. The bacteria under anaerobic conditions agar culture, growth spherical colony. Within the organization color yellow particles, commonly known as "sulfur particles," by the Department of mycelium from tangles. 0.8 gram-positive 0.5-1.0μm the mycelium Mission and the surrounding anatomy with mycelia, mycelium rod end was enlarged. Pathology and pathogenesis of pulmonary infection from bronchitis, a septic Huai granuloma, multiple small abscess formation. In abscess can be seen within the sulfur particles around for epithelioid cells, multinucleated giant cells, eosinophils and plasma cells. outside again for the fibrous lesions. Pleural lesions caused pleurisy or empyema, can break the chest wall and fistula formation. The disease characteristics of the destruction and proliferation simultaneously, the lesions healed scar at the same time, can still be extended to the surrounding tissue. Clinical manifestations of the more slow onset. Start low heat or irregular fever, cough, cough sputum little mucus. With the progress of disease, lung abscess formation of multiple, then add to the symptoms. There will be high fever, cough drama, a large number of mucopurulent sputum and blood-tinged sputum or hemoptysis, with weak, night sweat, anemia and weight loss. And the extension of pleural lesions can cause severe chest pain, chest wall is penetrated subcutaneous abscess and fistula formation, often mixed with discharges from septic block the law. Fistula organizations around pigmentation. Fistula'opening healed in its vicinity while there fistula. If mediastinal involvement, may cause respiratory or swallowing difficulties, severe cases can lead to death. Have lung abscess and pleural effusion signs. Early diagnosis in clinical and X-Buy no characteristic change, the diagnosis is more difficult. Diagnosed mainly rely on microbiology and histology. From pus, sputum or fistula wall tissue found sulfur particles, or anaerobic bacteria can develop diagnosed. Easier with the disease of tuberculosis, bronchial cancer and lung abscess confused; And Nocardia bacteria in clinical disease, X-ray findings of the pathogen and patterns quite similar, it should be noted differential. Nocardiosis often invasion of the central nervous system, very few fistula formation of the chest wall, there is no sputum sulfur particles, is 95.00. Treatment of penicillin G treatment effects. To large doses, according to the illness two million-10 million u / d intravenous infusion. Stable condition after reductions. Long courses, normally a three-month, or continue to use lesion inhalation far. If dissatisfied with the effect of penicillin, plus high-dose sulfa drugs (blood concentration of 5% ~ 10 mg), can improve the curative effect. If allergic to penicillin or ineffective treatment, can be used streptomycin, erythromycin, lincomycin, tetracycline and cephalosporins. Chest wall abscess or empyema must incision. Persistent Actinomycosis pulmonary granuloma, and fibrosis, bronchiectasis, chest wall, rib or lesions, fistula, and other available surgical resection. Auxiliary unilateral or bilateral lung scattered irregular Patchy infiltrates, integration into real change, which is irregular translucent, can be associated with pleural effusion. Disease spread to the ribs and spine, we can see signs of Periostitis, ribs or spine damage.