[Pleuro-mediastinitis in pulmonary actinomycosis as a rare differential bronchial carcinoma diagnosis].

A 48-year old patient complaining of immitigable coughing with purulent and sanguineous sputum and a loss of weight of 8 kg within the last three months was admitted to our hospital. Due to anamnesis and radiological findings (tumor of the right side upper lung field with infiltration of the chest wall and the mediastinum) we suspected a bronchogenic carcinoma. As bronchoscopy and histological examinations of biopsies revealed no hints to the underlying disease, we submitted the patient to a right side explorative thoracotomy. It showed a tumorous involvement of the right side upper lung field with infiltration and partial destruction of the chest wall and infiltration of the apical segment of the lower lobe of the lung and a phlegmonous infiltration of the paratracheal tissue. Histological examination confirmed chronical course of actinomycosis. Therapy consisted in resection of the affected tissue and long-term administration of antibiotics. Response to therapy was excellent concerning both radiological findings and subjective complaints.