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Endobronchial Actinomycosis Associated With Foreign Body*: Four Cases and a Review of the Literature

Stéphane Chouabe; Dominique Perdu, MD; Gaétan Deslée, MD; Dragisa Milosevic, MD; Elisabeth Marque, MD; François Lebargy, MD, PhD
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*From the Department of Respiratory and Allergic Diseases, Hôpital de la Maison Blanche, 51092 Reims, France.

Correspondence to: François Lebargy, MD, PhD, Service de Pneumologie, CHU de la Maison Blanche, 45 rue Cognacq Jay, 51092 Reims, France; e-mail: flebargy@chu-reims.fr



Chest. 2002;121(6):2069-2072. doi:10.1378/chest.121.6.2069
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Four cases of primary endobronchial actinomycosis associated with an inhaled foreign body are described. In the light of these cases and those previously reported in the literature, we describe the main features of this uncommon association. All patients were > 55 years old, were predominantly men, and were usually in a debilitated state. In > 50% of cases, the clinical presentation was suggestive of lung cancer. Thoracic CT rarely revealed a foreign body, but the granulomatous reaction of the bronchial wall was sometimes suggestive of bronchial thickening. Sulfur granules identified on bronchial biopsies were highly suggestive of actinomycosis in most cases, but microbiological culture findings were usually negative. Antibiotics generally ensure good recovery. Extraction of the foreign body was delayed after antibiotic therapy in one half of cases, suggesting the need for endoscopic follow-up in bronchial actinomycosis.

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