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HOME > Acute Crit Care > Volume 25(4); 2010 > Article
Case Report A Case Report of Rapidly Progressive Empyema Caused by Pulmonary Actinomycosis: A Case Report
Seong Joon Park, Young Chel Ahn, Soo Kyung Park, Min Jung Kim, Se Hun Kang, Hang Jea Jang, Younsuck Koh

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1Department of Internal Medicine, Asan Medical Center, Seoul, Korea.
2Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.

Pulmonary actinomycosis is an indolent and slowly progressive infectious disease, accompanied by pleural effusion and empyema in about 50% of cases. The size of the effusion is usually small, though, and it responds to appropriate antibiotics. We report a case of rapidly progressing, severe empyema leading to respiratory failure that was caused by pulmonary actinomycosis. A 57-year-old man presented with pleuritic chest pain for 5 days. The initial plain chest radiograph and CT scan showed pleural effusion. Gross pus was observed during the thoracentesis and laboratory test of pleural effusion revealed empyema. In spite of empirical antibiotics and chest tube drainage, the empyema rapidly progressed and the patient reached respiratory failure. Mechanical ventilation applied and decortication via video-assisted thoracotomy was performed. Microscopic examination of both the pleural and adjacent lung biopsy specimen revealed actinomycosis.

ACC : Acute and Critical Care