Mediastinal Actinomycosis: A Rare Mediastinal Pseudotumour
Actinomycosis, once fairly common and often catastrophic, has now become an occasional infection in the era of antibiotics. The infection is caused by a branching Gram-positive, facultative anaerobic microorganism Actinomycetes. Various forms of the diseases in decreasing order of their frequency...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2020-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/14017/43168_CE[Ra1]_F(KM)_PF1(AB_SL)_PFA(AB_SL)_PN(SL).pdf |
| Summary: | Actinomycosis, once fairly common and often catastrophic, has now become an occasional infection in the era of antibiotics.
The infection is caused by a branching Gram-positive, facultative anaerobic microorganism Actinomycetes. Various forms of
the diseases in decreasing order of their frequency include cervico-facial form, abdomino-pelvic form and thoracic form. The
thoracic involvement occurs in approximately 15% of all cases of actinomycosis. The disease presents with nonspecific signs and
symptoms and therefore establishment of a definitive diagnosis with clinical and radiological investigations is difficult. The clinical
and radiological picture mimics a number of other pulmonary conditions like cancer, tuberculosis, lung abscess and pneumonia. To
reach at a definitive diagnosis one needs to have a high degree of suspicion and carry out histopathological studies in order to look
for colonies of Actinomycetes as well as sulphur granules which are pathognomic for the infection. Here is a case of a 48-year-old
diabetic male presenting with complaints of pain and swelling of neck, fever, dysphagia, dyspnea and cough with a mediastinal
tumour like appearance on chest radiography. The patient underwent various noninvasive and invasive diagnostic modalities that
included Contrast Enhanced Computed Tomography (CECT), Ultrasonography (USG) of thorax and histopathological examination
of the cervical lymph nodes (level 2 and 3). The disease process was initially thought to be tubercular or malignant in origin which
later turned out to be an actinomycotic lesion which was confirmed on the histopathological study of the lymph node specimen,
that responded to antibiotics over a period of few months. |
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| ISSN: | 2249-782X 0973-709X |