[Pulmonary actinomycosis with chest wall fistula formation].

INTRODUCTION

Actinomycosis is a suppurative infection caused by bacteria of the genus actinomyces. It is a rare cause of pulmonary infection and can be difficult to diagnose as its presentation may mimic cancer or tuberculosis. In the absence of treatment of pulmonary lesions fistulae can develop. We report a case of pulmonary actinomycosis complicated by a chest wall fistula that was managed by the thoracic surgery unit at Chu Ibn Sina de Rabat.

CASE REPORT: A 45 year old man who was previously fit and well presented with a left sided chest wall swelling with cutaneous fistulae. Pulmonary auscultation revealed evidence of left apical consolidation. Otherwise clinical assessment was unremarkable. Plain chest radiology revealed left apical opacification. CT scanning revealed a left pulmonary mass and percutaneous biopsy confirmed the diagnosis of actinomycosis. The patient was started on treatment and experienced a clinical and radiological improvement sustained at one year's follow up.

CONCLUSION

We review the clinical and radiological characteristics of this condition as well as diagnostic difficulties, histological findings, therapeutic options and its natural history.